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Published byHoratio Watts Modified over 9 years ago
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Breast Cancer: The Profile Ma. Belen E. Tamayo,M.D. Medical Oncologist Makati Medical Center The Medical City
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Breast Cancer leading cause of cancer and cancer death among females worldwide estimated to affect 1 in 10 females during her lifetime
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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
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Clinical Presentation: lump in the breast skin dimpling skin retraction nipple discharge ulcerating breast mass pain in the breast
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Diagnosis: tissue biopsy (excision or FNA) mammography scintimammography MRI
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Management Depends on Several Factors: 1. Stage of the disease 2. Age 3. Menopausal status 4. Estrogen/Progesterone Receptors 5. Concomitant illness
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Management : I. Local Treatment A. Surgery 1.Breast-conservation surg + ALND + RT 2.Modified radical mastectomy
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B. Radiation Therapy Cobalt Linear Accelerator Indications: 1. Node positive tumors (II,III) 2. (+) margins of resection 3. As part of breast conservation treatment
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Indications of Radiation Therapy: 4. Local recurrence 5. Ulcerating lesions 6. Brain metastasis 7. Bone metastasis
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II. Systemic Treatment A. Cytotoxic chemotherapy B. Hormonal therapy
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Early Breast Cancer Trialist Collaborative Group (EBCTCG) confirmed that Tamoxifen and polychemotherapy reduced both recurrence and 10-year mortality Lancet 1992
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IS BREAST CANCER CURABLE? Yes No
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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)
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Chance for Cure rises after 5 to 10 years of no recurrence. Cure cannot be absolutely guaranteed.
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For Advanced or Metastatic Breast Cancer: Cure is not possible Disease control may be achieved with the use of chemotherapy or hormonal therapy
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Risk Factors of Dying from Breast Cancer: 1. Extent of metastasis 2. Co-morbid illnesses
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Surveillance Critical period is the 1st 3 years Requires follow-up every 3 months
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Symptoms warranting further investigation: chronic cough difficulty in breathing bone pains persistent headache abdominal enlargement &/or pain
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