Breast carcinoma is a common malignancy in females. Thankfully, with current treatment regimens, cure
and control of disease are often achievable.
In early stage breast cancer, patients are given the
choice of having breast conserving therapy or mastectomy.
With breast conserving therapy, the breast
tumor is excised and sentinel lymph / axillary nodes are sampled (patients with non-invasive breast cancer do not usually
have nodes sampled). Chemotherapy is delivered if needed, based on the pathology from this surgery. After chemotherapy, radiation
therapy is delivered to the breast (and sometimes to draining lymphatics). Hormonal therapy or biological therapy may be offered
after chemotherapy or after radiation therapy.
During a mastectomy, the entire breast is removed and
the nodes biopsied. Chemotherapy is delivered, if needed, after the mastectomy for invasive disease. Radiation therapy to
the chest wall may be offered, depending on the pathology of the breast tissue and the lymph nodes.
- Breast conserving
surgery is as effective as mastectomy in early Breast Carcinoma.
- Risk Factors for breast cancer include:
- Family
history of breast cancer
- Prior breast cancer
- Age over 60
- BRCA1, BRCA2 gene positivity
- over
weight after menopause
- alcohol consumption
- lack of exercise
- not having children or having children
at a later age
- hormone replacement therapy (estrogen) during and after menopause
Symptoms
Early breast cancer is usually asymptomatic and but may be present on mammograms. Patients may find a lump
or experience a change in how their breast feels. A nipple discharge may be noticed as well. Advanced breast cancers are often
apparent to the patient usually with the discovery of a mass involving the breast or axilla, (lymph nodes under the arm).
Diagnosis
Mammogram, ultrasound and MRI are common tests utilized in the initial
diagnosis of breast cancer. An ultrasound guided needle biopsy is often performed to make the diagnosis. After the diagnosis
is made, the metastatic work up performed may include CT scans of the chest/abdomen and pelvis, PET/CT scan, and bone scan.
Staging
The size of the tumor, lymph node status, and the outcome of metastatic
work up determines the stage of disease.
BREAST CANCER
