|
|
| (66 intermediate revisions by 16 users not shown) |
| Line 1: |
Line 1: |
| | __NOTOC__ |
| | {{Breast cancer}} |
| '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' | | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| {{Infobox_Disease |
| |
| Name = Breast cancer |
| |
| DiseasesDB = 1598 |
| |
| ICD10 = {{ICD10|C|50||c|50}} |
| |
| ICD9 = {{ICD9|174}}-{{ICD9|175}} |
| |
| ICDO = |
| |
| OMIM = 114480 |
| |
| MedlinePlus = 000913 |
| |
| MeshID = D001943 |
| |
| }}
| |
| {{Breast cancer}}
| |
| {{CMG}}; '''Assistant Editor(s)-In-Chief:''' [[User:Jack Khouri|Jack Khouri]]
| |
|
| |
|
| ==[[Breast cancer overview|Overview]]==
| | {{CMG}} {{AE}} {{Soroush}} {{MGS}} {{Ammu}} |
|
| |
|
| ==[[Breast cancer classification|Classification]]==
| | {{SK}} Breast cancers, Breast carcinoma, Breast carcinomas, Breast neoplasm, Breast tumor, Breast tumors, Breast tumour, Breast malignancy |
| [[Breast cancer classification#Major Scheme|Major Scheme]] | [[Breast cancer classification#Staging|Staging]] | [[Breast cancer classification#Pathologic Types|Pathologic Types]] | [[Breast cancer classification#Histologic Types|Histologic Types]]
| |
|
| |
|
| ==[[Breast cancer epidemiology and demograhics|Epidemiology and Demographics]]== | | ==[[Breast cancer overview|Overview]]== |
|
| |
|
| ==[[Breast cancer physical examination|Physical Examination]]== | | ==[[Breast cancer historical perspective|Historical Perspective]]== |
|
| |
|
| ==[[Breast cancer screening|Screening]]== | | ==[[Breast cancer classification|Classification]]== |
| [[Breast cancer screening#X-ray mammography|X Ray Mammography]] | [[Breast cancer screening#Breast MRI|Breast MRI]] | [[Breast cancer screening#Breast ultrasound|Breast Ultrasound]] | [[Breast cancer screening#Breast self-exam|Self Exam]] | [[Breast cancer screening#Genetic testing|Genetic Testing]]
| |
|
| |
|
| ==Diagnosis== | | ==[[Breast cancer pathophysiology|Pathophysiology]]== |
| Breast cancer is diagnosed by the examination of surgically removed breast tissue. A number of procedures can obtain tissue or cells prior to definitive treatment for histological or cytological examination. Such procedures include fine-needle aspiration, nipple aspirates, ductal lavage, core needle biopsy, and local surgical excision. These diagnostic steps, when coupled with radiographic imaging, are usually accurate in diagnosing a breast lesion as cancer. Occasionally, pre-surgical procedures such as fine needle aspirate may not yield enough tissue to make a diagnosis, or may miss the cancer entirely. Imaging tests are sometimes used to detect [[metastasis]] and include [[chest X-ray]], [[bone scan]], [[Cat scan]], [[MRI]], and [[Positron emission tomography|PET]] scanning. While imaging studies are useful in determining the presence of metastatic disease, they are not in and of themselves diagnostic of cancer. Only microscopic evaluation of a biopsy specimen can yield a cancer diagnosis. Ca 15.3 (carbohydrate antigen 15.3, epithelial mucin) is a [[tumor marker]] determined in blood which can be used to follow disease activity over time after definitive treatment. Blood tumor marker testing is not routinely performed for the screening of breast cancer, and has poor performance characteristics for this purpose. | |
|
| |
|
| ==Staging== | | ==[[Breast cancer causes|Causes]]== |
| Breast cancer is [[Cancer staging|staged]] according to the TNM system, updated in the American Joint Committee on Cancer (AJCC) Staging Manual, now on its sixth edition. Prognosis is closely linked to results of staging, and staging is also used to allocate patients to treatments both in clinical trials and clinical practice. | |
|
| |
|
| '''Summary of stages:'''
| | ==[[Breast cancer differential diagnosis|Differentiating Breast Cancer from other Diseases]]== |
| * ''Stage 0'' - [[Carcinoma in situ]]
| |
| * ''Stage I'' - Tumor (T) does not involve axillary lymph nodes (N).
| |
| * ''Stage IIA'' – T 2-5 cm, N negative, or T <2 cm and N positive.
| |
| * ''Stage IIB'' – T > 5 cm, N negative, or T 2-5 cm and N positive (< 4 axillary nodes).
| |
| * ''Stage IIIA'' – T > 5 cm, N positive, or T 2-5 cm with 4 or more axillary nodes
| |
| * ''Stage IIIB'' – T has penetrated chest wall or skin, and may have spread to < 10 axillary N
| |
| * ''Stage IIIC'' – T has > 10 axillary N, 1 or more supraclavicular or infraclavicular N, or internal mammary N.
| |
| * ''Stage IV'' – Distant metastasis (M)
| |
|
| |
|
| Breast lesions are examined for certain markers, notably sex steroid hormone receptors.
| | ==[[Breast cancer epidemiology and demographics|Epidemiology and Demographics]]== |
| About two thirds of postmenopausal breast cancers are [[estrogen receptor]] positive (ER+) and [[progesterone receptor]] positive (PR+).<ref>Rusiecki JA, Holford TR, Zahm SH, Zheng T. Breast cancer risk factors according to joint estrogen receptor and progesterone receptor status. Cancer Detect Prev 2005;29:419-26</ref> Receptor status modifies the treatment as, for instance, only ER-positive tumors, not ER-negative tumors, are sensitive to hormonal therapy.
| |
|
| |
|
| The breast cancer is also usually tested for the presence of human epidermal growth factor receptor 2, a protein also known as HER2, neu or erbB2. HER2 is a cell-surface protein involved in cell development. In normal cells, HER2 controls aspects of cell growth and division. When activated in cancer cells, HER2 accelerates tumor formation. About 20-30% of breast cancers overexpress HER2. Those patients may be candidates for the drug [[trastuzumab]], both in the postsurgical setting (so-called "[[adjuvant]]" therapy), and in the metastatic setting.<ref>[http://www.cancer.gov/cancertopics/factsheet/therapy/herceptin, accessed 1/30/07 cancer.gov]</ref>
| | ==[[Breast cancer risk factors|Risk factors]]== |
|
| |
|
| ==Treatment== | | ==[[Breast cancer screening|Screening]]== |
| {{main|Breast cancer treatment}}
| | [[Breast cancer screening#X-ray mammography|X Ray Mammography]] | [[Breast cancer screening#Breast MRI|Breast MRI]] | [[Breast cancer screening#Breast ultrasound|Breast Ultrasound]] | [[Breast cancer screening#Breast self-exam|Self Exam]] | [[Breast cancer screening#Genetic testing|Genetic Testing]] |
| The mainstay of breast cancer treatment is [[surgery]] when the tumor is localized, with possible adjuvant hormonal therapy (with [[tamoxifen]] or an [[aromatase inhibitor]]), [[chemotherapy]], and/or [[radiotherapy]]. At present, the treatment recommendations after surgery (adjuvant therapy) follow a pattern. This pattern is subject to change, as every two years, a worldwide conference takes place in St. Gallen, Switzerland, to discuss the actual results of worldwide multi-center studies. Depending on clinical criteria (age, type of cancer, size, metastasis) patients are roughly divided to high risk and low risk cases, with each risk category following different rules for therapy. Treatment possibilities include radiation therapy, chemotherapy, hormone therapy, and immune therapy.
| |
|
| |
|
| In planning treatment, doctors can also use PCR tests like [[Oncotype DX]] or [[microarray]] tests like [[MammaPrint]] that predict breast cancer recurrence risk based on gene expression. In February 2007, the MammaPrint test became the first breast cancer predictor to win formal approval from the [[Food and Drug Administration]]. This is a new gene test to help predict whether women with early-stage breast cancer will relapse in 5 or 10 years, this could help influence how aggressively the initial tumor is treated.<ref name="NewsMax">"[http://newsmax.com/archives/articles/2007/2/6/130740.shtml FDA Approves New Breast Cancer Test]". Associated Press, February 6, 2007.</ref>
| | ==[[Breast cancer natural history|Natural History, Complications and Prognosis]]== |
|
| |
|
| ==[[Breast cancer primary prevention|Primary Prevention]]== | | ==Diagnosis== |
| [[Breast cancer primary prevention#Phytoestrogens and soy|Phytoestrogens and Soy]] | [[Breast cancer primary prevention#Folic acid (folate)|Folic Acid (Folate)]] | [[Breast cancer primary prevention#Oophorectomy and mastectomy|Oophorectomy and Mastectomy]] | [[Breast cancer primary prevention#Medications|Medications]] | | [[Breast cancer diagnostic study of choice|Diagnostic Study of Choice]]| [[Breast Biopsy]]|[[Breast cancer history and symptoms| History and Symptoms]] | [[Breast cancer physical examination | Physical Examination]] |[[Breast cancer laboratory tests | Laboratory Findings]] | Electrocardiogram| [[Breast cancer chest x ray|X Ray]] | [[Breast cancer CT|CT]] scan| [[Breast cancer MRI|MRI]] | [[Breast cancer echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Breast cancer other imaging studies|Other Imaging Studies]] | [[Breast cancer other diagnostic studies|Other Diagnostic Studies]] |
| | | |
| ==Prognosis==
| |
| There are several prognostic factors associated with breast cancer. [[Cancer staging|Stage]] is the most important, as it takes into consideration local involvement, lymph node status and whether metastatic disease is present. The higher the stage at diagnosis, the worse the prognosis. Breast cancer patients whose lymph nodes are cancer-free have a much better prognosis than those whose lymph nodes are positive for cancer.
| |
| | |
| The presence of estrogen and progesterone receptors in the cancer cell is another important prognostic factor which may guide treatment. Hormone receptor positive breast cancer is usually associated with much better prognosis compared to hormone negative breast cancer.
| |
| | |
| [[HER2/neu]] status has also been described as a prognostic factor. Patients whose cancer cells are positive for HER2/neu have more aggressive disease and may be treated with [[trastuzumab]], a [[monoclonal antibody]] that targets this protein. | |
| | |
| ===Psychological aspects of diagnosis and treatment===
| |
| The emotional impact of cancer diagnosis, symptoms, treatment, and related issues can be severe. Most larger hospitals are associated with [[cancer support group]]s which can help patients cope with the many issues that come up in a supportive environment with other people with experience with similar issues. Online [[cancer support group]]s are also very beneficial to cancer patients, especially in dealing with uncertainty and body-image problems inherent in cancer treatment.
| |
| | |
| ==Metastasis==
| |
| Most people understand breast cancer as something that happens in the breast. However it can [[metastasis]]e (spread) via lymphatics to nearby lymph nodes, usually those under the arm. That is why surgery for breast cancer always involves some type of surgery for the glands under the arm — either axillary clearance, sampling, or sentinel node biopsy.
| |
| | |
| Breast cancer can also spread to other parts of the body via blood vessels. So it can spread to the lungs, pleura (the lining of the lungs), liver, brain, and most commonly to the bones. Seventy percent of the time that breast cancer spreads to other locations, it spreads to bone, especially the vertebrae and the long bones of the arms, legs, and ribs. Breast cancer cells "set up house" in the bones and form tumors. Usually when breast cancer spreads to bone, it eats away healthy bone, causing weak spots, where the bones can break easily. That is why breast cancer patients are often seen wearing braces or using a wheelchair, and why they complain about aching bones.
| |
| | |
| When breast cancer is found in bones, it has usually spread to more than one site. At this stage, it is treatable, often for many years, but it is not curable. Like normal breast cells, these tumors in the bone often thrive on female hormones, especially estrogen. Therefore, the doctor often treats the patient with medicines that lower her estrogen levels.
| |
| | |
| ==History==
| |
| Breast cancer may be one of the oldest known forms of cancer tumors in humans. The oldest description of cancer (although the term cancer was not used) was discovered in Egypt and dates back to approximately 1600 BC. The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by [[cauterization]].The writing says about the disease, "There is no treatment."<ref>{{cite web
| |
| | title = The History of Cancer
| |
| | work = [[American Cancer Society]]
| |
| | date = 2002-03-25
| |
| | url = http://www.cancer.org/docroot/CRI/content/CRI_2_6x_the_history_of_cancer_72.asp?sitearea=CRI
| |
| | accessdate = 2006-10-09 }}</ref> For centuries, physicians described similar cases in their practises, with the same sad conclusion. It wasn't until doctors achieved greater understanding of the circulatory system in the 17th century that they could establish a link between breast cancer and the [[lymph nodes]] in the armpit. The French surgeon [[Jean Louis Petit]] (1674-1750) and later the Scottish surgeon [[Benjamin Bell]] (1749-1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle. Their successful work was carried on by [[William Stewart Halsted]] who started performing [[radical mastectomy|mastectomies]] in 1882. He became known for his [[radical mastectomy|Halsted radical mastectomy]], a surgical procedure that remained popular up to the 1970s.
| |
|
| |
|
| ==Cultural references==
| |
| [[Image:Pink ribbon.svg| 80px | right]]
| |
| In the month of October, breast cancer is recognized by survivors, family and friends of survivors and/or victims of the disease. A pink ribbon is worn to recognize the struggle that sufferers face when battling the cancer.
| |
|
| |
|
| Pink for October is an initiative started by Matthew Oliphant, which asks that any sites willing to help make people aware of breast cancer, change their template or layout to include the color pink, so that when visitors view the site, they see that the majority of the site is pink. Then after reading a short amount of information about breast cancer, or being redirected to another site, they are aware of the disease itself.
| | ==[[Breast cancer treatment|Treatment]]== |
| | [[Breast cancer Medical therapy|Medical Therapy]]| [[Breast cancer Surgery|Surgery]] | [[Breast cancer bone metastasis|Bone Metastasis]]| [[Breast cancer primary prevention|Primary Prevention]] | [[Breast cancer cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Breast cancer future or investigational therapies|Future or Investigational Therapies]] |
|
| |
|
| The patron saint of breast cancer is Saint Agatha of Sicily.
| | ==Case Studies== |
| | [[Breast cancer case study one|Case #1]] |
|
| |
|
| ==Related Chapters== | | ==Related Chapters== |
| <div style="-moz-column-count:2; column-count:2;"> | | <div style="-moz-column-count:2; column-count:2;"> |
| *[[List of breast carcinogenic substances]] | | *[[List of breast carcinogenic substances]] |
| *[[Mammary tumor]] for breast cancer in other animals
| |
| *[[Breast reconstruction]] | | *[[Breast reconstruction]] |
| *[[Alcohol and cancer]] | | *[[Alcohol and cancer]] |
| *[[Mammography Quality Standards Act]] | | *[[Mammography Quality Standards Act]] |
| *National Breast Cancer Coalition
| |
| *[[National Comprehensive Cancer Network]] | | *[[National Comprehensive Cancer Network]] |
| *[[Breast Cancer Action]] | | *[[Breast Cancer Action]] |
| Line 105: |
Line 54: |
| *[[Susan G. Komen for the Cure]] | | *[[Susan G. Komen for the Cure]] |
| </div> | | </div> |
|
| |
| ==References==
| |
| <!-- ---------------------------------------------------------------
| |
| See http://en.wikipedia.org/wiki/Wikipedia:Footnotes for a
| |
| discussion of different citation methods and how to generate
| |
| footnotes using the <ref> & </ref> tags and the {{Reflist}} template
| |
| -------------------------------------------------------------------- -->
| |
|
| |
| {{Reflist|2}}
| |
|
| |
|
| ==External links== <!-- Before adding links, make sure they meet the requirements as noted in [[WP:EL]] or they may be removed. --> | | ==External links== <!-- Before adding links, make sure they meet the requirements as noted in [[WP:EL]] or they may be removed. --> |
| Line 132: |
Line 72: |
| * [http://www.cancer.org/docroot/LRN/LRN_0.asp?dt=5 American Cancer Society - Learn About Breast Cancer Page] | | * [http://www.cancer.org/docroot/LRN/LRN_0.asp?dt=5 American Cancer Society - Learn About Breast Cancer Page] |
| * [http://www.cancer.gov/cancertopics/types/breast National Cancer Institute: Breast Cancer] | | * [http://www.cancer.gov/cancertopics/types/breast National Cancer Institute: Breast Cancer] |
| * [http://www.imaginis.com Imaginis -Award winning Breast Cancer site]
| |
|
| |
| ===Research and statistics===
| |
| * [http://www.emaxhealth.com/98/ eMaxHealth Breast Cancer] Publishes Research News on Breast Cancer from Research Institutions and Universities
| |
|
| |
|
| ===Clinical=== | | ===Clinical=== |
| * [http://www.radiologyinfo.org/en/info.cfm?pg=breastcancer RadiologyInfo] - The radiology information resource for patients: Breast Cancer
| |
| * [http://www.center4research.org/pdf/booklet04bc.pdf Surgery Choices for Women with Early-Stage Breast Cancer, National Cancer Institute] | | * [http://www.center4research.org/pdf/booklet04bc.pdf Surgery Choices for Women with Early-Stage Breast Cancer, National Cancer Institute] |
| * [http://www.center4research.org/bc071502.html Mastectomy vs.n Lumpectomy: Who Decides?, National Research Center for Women & Families] | | * [http://www.center4research.org/bc071502.html Mastectomy vs.n Lumpectomy: Who Decides?, National Research Center for Women & Families] |
| * Australia: ''Cancer Control Bulletin'' [http://www.sesiahs.health.nsw.gov.au/publications/cancerControl/26%20Alcohol.PDF Alcohol and cancer risk]
| |
|
| |
|
| ===Videos===
| | {{WikiDoc Help Menu}} |
| *[http://www.healthination.com/breast_cancer.php Health Video: Breast Cancer - Overview, Prevention and Treatment]
| | {{WikiDoc Sources}} |
|
| |
|
| [[Category:Disease state]] | | [[Category:Disease]] |
| [[Category:Types of cancer]] | | [[Category:Types of cancer]] |
| [[Category:Breast]] | | [[Category:Breast]] |
| Line 152: |
Line 86: |
| [[Category:Oncology]] | | [[Category:Oncology]] |
| [[Category:Mature chapter]] | | [[Category:Mature chapter]] |
| | | [[Category:Up-To-Date]] |
| [[ar:سرطان الثدي]]
| | [[Category:Oncology]] |
| [[bs:Tumori dojke]]
| | [[Category:Medicine]] |
| [[bg:Рак на гърдата]]
| | [[Category:Gynecology]] |
| [[da:Brystkræft]]
| | [[Category:Surgery]] |
| [[de:Brustkrebs]]
| |
| [[es:Cáncer de mama]]
| |
| [[fa:سرطان پستان]]
| |
| [[fr:Cancer du sein]]
| |
| [[hr:Rak dojke]]
| |
| [[id:Kanker payudara]]
| |
| [[it:Carcinoma mammario]]
| |
| [[he:סרטן השד]]
| |
| [[ka:მკერდის კიბო]]
| |
| [[mk:Рак на дојка]]
| |
| [[ms:Penyakit barah payudara]]
| |
| [[nl:Borstkanker]]
| |
| [[ja:乳癌]]
| |
| [[no:Brystkreft]]
| |
| [[pl:Rak sutka]]
| |
| [[pt:Câncer de mama]]
| |
| [[ro:Cancer mamar]]
| |
| [[ru:Злокачественные новообразования молочной железы]]
| |
| [[simple:Breast cancer]]
| |
| [[sk:Karcinóm prsníka]]
| |
| [[fi:Rintasyöpä]]
| |
| [[sv:Bröstcancer]]
| |
| [[th:มะเร็งเต้านม]] | |
| [[vi:Ung thư vú]] | |
| [[tr:Meme kanseri]] | |
| [[ur:سرطان پستان]] | |
| [[zh:乳癌]] | |
| | |
| {{WikiDoc Help Menu}}
| |
| {{WikiDoc Sources}}
| |