Diagnosing breast cancer is a vital step towards its treatment. Yes clinically surgeon can diagnose breast cancer, but with out diagnostic investigations surgeon may not be sure about its involvement, extension and severity.There are many advanced investigations available for diagnosing breast cancer.
The diagnosis depands on:
A. Imaging techniques.
B. Lab findings.
C. Pathology study.
Imaging techniques: Even though more than 60% of cases presented to hospital are self detected ( by breast self examination), Mammography is the most reliable means of detecting breast cancer before a mass can be palpated. Patients with a dominant or suspicious mass must undergo biopsy despite mammographic findings. MRI & ultrasonography may be a useful screening modalities in women who are at high risk. Advanced tool like PET (positron emmission tomography ) also used for diagnostic purpose.
imaging procedures like Chest radiography, CT scan are used to detect the distant metastasis. When bony metastases are suspected 99mTc labelled phosphates ar used for bone scanning.
Lab findings- Increased level of calcium is an occasional important finding in advanced cancer of breast. carcino-embryonic antigen ( CEA ) & CA15-3 or CA27-29 may be used as marker for recurrent Breast cancer. Hormonal studies also been carried out to make the diagnosis easier.
Pathology study-The diagnosis of breast cancer depends ultimately on examination of tissue or cells removed by biopsy. treatment should never be undertaken without an histological or cytological studies. The simplest biopsy method is needle biopsy, either by aspiration of tumor cell by FNA(fine needle aspiration) or by obtaining a small core of tissue with hollow needle ( core biopsy). Open biopsy under local anasthesia as a seperate procedure prior to definitive treatment is most reliable means of diagnosis.
Monday, July 13, 2009
Sunday, July 12, 2009
Breast cancer treatment
Breast cancer treatment is not as easy as diagnosing it. Treatment depends on its size extension & metastasis. broadly treatment is categorised in to medical, surgical and follow up.
Medical treatment
It is applied in early stage where surgical intervention is not required. This includes chemotherapy , hormonal therapy. The treatment module is not the same for all breast cancers, it varies. Like in fibrocystic condition drugs like danazol, tamoxifen hepls to reduce symptoms, but because of its side effects its usage is restricted . Gamolenic acid has been shown to decrease pain. Studies also shows intake of Vitamin E hasbeen helpful.
In carcinoma of breast , hormonal therapy is most commonly adviced in post menopausal women. drugs like Trastuzumab, Tamoxifen, Arimidex been used for it.
Chemotherapy is usually done following surgery, used to eliminate occult metastasis in distant organ and it may also decrease local recurrence. drugs like cyclophosphamide , methotrexate, doxorubicin, epirubicin, fluorouracil are been used. the duration of the therapy ranges from 3months to 12 months.
Neoadjuvant therapy has shown effective results in carcinoma of breast, this is the usage of chemotherapy or hormonal therapy prior to resection of primary lesion & is getting popular now.
Surgical treatment:
The main aim of surgeries in breast cancer is
A. To preserve breast structure as much as possible.
B. To intervent the progress of the disease.
C. To improve the life survival after surgical.
It includes procedures like lumpectomy, total mastectomy, partial mastectomy, modified radical mastectomy, these surgeries has its own merits. Surgical treatment is often followed by radiotherapy. radiotherapy after surgery increases survival of patients.
Irradiation also been used where cancer lesion is single , local , resection done followed by irradiation for 1-2 weeks.
Follow up:
After treatment , patients should be monitored for life in order to detect recurrence. because local and distant recurrences occur most frequently within first 2-5years. During first 2 years patient should be examined every 6months and later annually.
Medical treatment
It is applied in early stage where surgical intervention is not required. This includes chemotherapy , hormonal therapy. The treatment module is not the same for all breast cancers, it varies. Like in fibrocystic condition drugs like danazol, tamoxifen hepls to reduce symptoms, but because of its side effects its usage is restricted . Gamolenic acid has been shown to decrease pain. Studies also shows intake of Vitamin E hasbeen helpful.
In carcinoma of breast , hormonal therapy is most commonly adviced in post menopausal women. drugs like Trastuzumab, Tamoxifen, Arimidex been used for it.
Chemotherapy is usually done following surgery, used to eliminate occult metastasis in distant organ and it may also decrease local recurrence. drugs like cyclophosphamide , methotrexate, doxorubicin, epirubicin, fluorouracil are been used. the duration of the therapy ranges from 3months to 12 months.
Neoadjuvant therapy has shown effective results in carcinoma of breast, this is the usage of chemotherapy or hormonal therapy prior to resection of primary lesion & is getting popular now.
Surgical treatment:
The main aim of surgeries in breast cancer is
A. To preserve breast structure as much as possible.
B. To intervent the progress of the disease.
C. To improve the life survival after surgical.
It includes procedures like lumpectomy, total mastectomy, partial mastectomy, modified radical mastectomy, these surgeries has its own merits. Surgical treatment is often followed by radiotherapy. radiotherapy after surgery increases survival of patients.
Irradiation also been used where cancer lesion is single , local , resection done followed by irradiation for 1-2 weeks.
Follow up:
After treatment , patients should be monitored for life in order to detect recurrence. because local and distant recurrences occur most frequently within first 2-5years. During first 2 years patient should be examined every 6months and later annually.
Friday, July 10, 2009
Breast cancer symptoms
Seeing from outside bread cancer might sound like a single disease, infact it is a term used to cover all cancer lesion within breast.it could be benign or malignant. Women suffering from breast cancer express either a single form of cancer or a multiple involvement. thus the symptoms are not all the same, for it varies in difference. lets discuss broadly.
Some of the breast cancer like fibroadenoma, fibrocystic produces asymptomatic mass ( lump )in breast, which are discovered accidently. here age plays a major role in diagnosing it, fibroadenoma predominantly occurs in younger age group i.e. within 20 years from menarche, whereas fibrocystic occurs around 40 years of age.
usually at early stage in breast cancer women often experiences discomfort in involved breast which worses during premenstrual phase of cycle. more than 70% of cases presents with painless mass predominantly in upper and outer quadrant of breast. Other symptoms may include breast pain, nipple discharge, enlarged nipple, itchy nipple, generalised hardness enlarged or shrinking of breast, orange skin like appearance on breast. women who are at risk of developing breast cancer should do regular self examination to discover at early most..
Some of the breast cancer like fibroadenoma, fibrocystic produces asymptomatic mass ( lump )in breast, which are discovered accidently. here age plays a major role in diagnosing it, fibroadenoma predominantly occurs in younger age group i.e. within 20 years from menarche, whereas fibrocystic occurs around 40 years of age.
usually at early stage in breast cancer women often experiences discomfort in involved breast which worses during premenstrual phase of cycle. more than 70% of cases presents with painless mass predominantly in upper and outer quadrant of breast. Other symptoms may include breast pain, nipple discharge, enlarged nipple, itchy nipple, generalised hardness enlarged or shrinking of breast, orange skin like appearance on breast. women who are at risk of developing breast cancer should do regular self examination to discover at early most..
Thursday, July 9, 2009
Risk factors
Breast cancer posses a greater threat to women. Next to skin cancer, breast cancer is the most common cancer in women. most women in whom breast cancer has been diagnosed do not have an obvious risk factors, but there are some risk factors do have role in breast cancer.
The risk factors are:
A. Risk of developing Breast cancer is assosiated with increase in age.
B. Breast cancer is 3-4 times more likely to develop in women with a first-degree relative ( mother , sister ) who had breast cancer than in those without a family history.
C. Nulliparous women and women whose first pregnancy after 35 years of age.
D. Early menarche (under age 12 ) and late menopause are assosiated with a increased risk.
E. Breast cancer is more common in white women.
F. There is strong assosiation of genetic mutation BRCA1, BRCA2 with breast cancer.
G. Dietary factors, particularly increased fat consumption also plays role as risk factor.
Studies shows that breast cancer are high in developed countries.
The risk factors are:
A. Risk of developing Breast cancer is assosiated with increase in age.
B. Breast cancer is 3-4 times more likely to develop in women with a first-degree relative ( mother , sister ) who had breast cancer than in those without a family history.
C. Nulliparous women and women whose first pregnancy after 35 years of age.
D. Early menarche (under age 12 ) and late menopause are assosiated with a increased risk.
E. Breast cancer is more common in white women.
F. There is strong assosiation of genetic mutation BRCA1, BRCA2 with breast cancer.
G. Dietary factors, particularly increased fat consumption also plays role as risk factor.
Studies shows that breast cancer are high in developed countries.
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