Transcript Breast Cancer: The Profile

Breast Cancer: The Profile
Ma. Belen E. Tamayo,M.D.
Medical Oncologist
Makati Medical Center
The Medical City
Breast Cancer
•
leading cause of cancer and
cancer death among females
worldwide
•
estimated to affect 1 in 10
females during her lifetime
Risk Factors:
1. Female gender
2. Hormonal factors
3. Family history
particularly 1st degree
relatives (mother, sisters)
4. Previous breast cancer
5. (+)BRCA-1, BRCA-2 gene
Clinical Presentation:
• lump in the breast
• skin dimpling
• skin retraction
• nipple discharge
• ulcerating breast mass
• pain in the breast
Diagnosis:
• tissue biopsy (excision or FNA)
• mammography
• scintimammography
• MRI
Management Depends on Several
Factors:
1. Stage of the disease
2. Age
3. Menopausal status
4. Estrogen/Progesterone
Receptors
5. Concomitant illness
Management :
I. Local Treatment
A. Surgery
1.Breast-conservation surg
+ ALND + RT
2.Modified radical
mastectomy
B. Radiation Therapy
Cobalt
Linear Accelerator
Indications:
1. Node positive tumors (II,III)
2. (+) margins of resection
3. As part of breast conservation
treatment
Indications of Radiation Therapy:
4. Local recurrence
5. Ulcerating lesions
6. Brain metastasis
7. Bone metastasis
II. Systemic Treatment
A. Cytotoxic chemotherapy
B. Hormonal therapy
Early Breast Cancer Trialist
Collaborative Group (EBCTCG)
confirmed that Tamoxifen
and polychemotherapy
reduced both recurrence and
10-year mortality
Lancet 1992
IS BREAST CANCER
CURABLE?
Yes
No
Prognostic Factors For Recurrence:
1. Age
2. Cancer Stage at the time of
initial diagnosis
(Stage III > II > I )
3. Treatment given after surgery
(adjuvant therapy)
•Chance for Cure rises after
5 to 10 years of no recurrence.
•Cure cannot be absolutely
guaranteed.
For Advanced or Metastatic Breast
Cancer:
• Cure is not possible
• Disease control may be
achieved with the use of
chemotherapy or hormonal
therapy
Risk Factors of Dying from
Breast Cancer:
1. Extent of metastasis
2. Co-morbid illnesses
Surveillance
• Critical period is the 1st 3 years
• Requires follow-up every 3
months
Symptoms warranting further
investigation:
• chronic cough
• difficulty in breathing
• bone pains
• persistent headache
• abdominal enlargement &/or
pain