Breast cancer
For patient information click here
| Breast cancer | |
| ICD-10 | C50 |
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| ICD-9 | 174-175 |
| OMIM | 114480 |
| DiseasesDB | 1598 |
| MedlinePlus | 000913 |
| MeSH | D001943 |
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Breast Cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Breast cancer On the Web |
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American Roentgen Ray Society Images of Breast cancer |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-In-Chief: Jack Khouri
Overview
Historical Perspective
Classification
Major Scheme | Staging | Pathologic Types | Histologic Types
Epidemiology and Demographics
Physical Examination
Screening
X Ray Mammography | Breast MRI | Breast Ultrasound | Self Exam | Genetic Testing
Natural History, Complications and Prognosis
Diagnosis
Staging
Breast cancer is 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:
- 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. About two thirds of postmenopausal breast cancers are estrogen receptor positive (ER+) and progesterone receptor positive (PR+).[1] 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.[2]
Treatment
Chemotherapy | Bone Metastasis | Metastatic Breast Cancer Treatment
Primary Prevention
Phytoestrogens and Soy | Folic Acid (Folate) | Oophorectomy and Mastectomy | Medications
Metastasis
Most people understand breast cancer as something that happens in the breast. However it can metastasise (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.
Related Chapters
- List of breast carcinogenic substances
- Mammary tumor for breast cancer in other animals
- Breast reconstruction
- Alcohol and cancer
- Mammography Quality Standards Act
- National Breast Cancer Coalition
- National Comprehensive Cancer Network
- Breast Cancer Action
- Breakthrough Breast Cancer
- Barron Lerner (Physician)
- William Stewart Halsted (Radical Mastectomy)
- International Agency for Research on Cancer
- The Hormone Foundation
- Susan G. Komen for the Cure
References
- ↑ 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
- ↑ accessed 1/30/07 cancer.gov
External links
- Breast localisation and excision: Operation Script on Wikisurgery.
- Breast localisation and excision : Information for patients on Wikisurgery.
- Breast subareolar excision : Operation Script on Wikisurgery.
- Breast subareolar excision daycase : Information for patients on Wikisurgery.
- Breast wide excision: Operation Script on Wikisurgery.
- Breast wide excision: Information for patients on Wikisurgery.
- Fine needle aspiration: Operation Script on Wikisurgery.
- Mastectomy: Operation Script on Wikisurgery.
- Mastectomy: Information for patients on Wikisurgery.
- Mastectomy subcutaneous male daycase: Information for patients on Wikisurgery.
- Trucut needle biopsy: Operation Script on Wikisurgery.
General
- American Cancer Society - Learn About Breast Cancer Page
- National Cancer Institute: Breast Cancer
- Imaginis -Award winning Breast Cancer site
Research and statistics
- eMaxHealth Breast Cancer Publishes Research News on Breast Cancer from Research Institutions and Universities
Clinical
- RadiologyInfo - The radiology information resource for patients: Breast Cancer
- Surgery Choices for Women with Early-Stage Breast Cancer, National Cancer Institute
- Mastectomy vs.n Lumpectomy: Who Decides?, National Research Center for Women & Families
- Australia: Cancer Control Bulletin Alcohol and cancer risk