Breast Cancer: The Profile

1
Breast Cancer The Profile

• Ma. Belen E. Tamayo,M.D.
• Medical Oncologist
• Makati Medical Center
• The Medical City

2

• Breast Cancer
• leading cause of cancer and
• cancer death among females
• worldwide
• estimated to affect 1 in 10
• females during her lifetime

3

• 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

4

• Clinical Presentation
• lump in the breast
• skin dimpling
• skin retraction
• nipple discharge
• ulcerating breast mass
• pain in the breast

5

• Diagnosis
• tissue biopsy (excision or FNA)
• mammography
• scintimammography
• MRI

6

• Management Depends on Several Factors
• 1. Stage of the disease
• 2. Age
• 3. Menopausal status
• 4. Estrogen/Progesterone
• Receptors
• 5. Concomitant illness

7

• Management
• I. Local Treatment
• A. Surgery
• 1.Breast-conservation surg
• ALND RT
• 2.Modified radical
• mastectomy

8

• B. Radiation Therapy
• Cobalt
• Linear Accelerator
• Indications
• 1. Node positive tumors (II,III)
• 2. () margins of resection
• 3. As part of breast conservation
• treatment

9

• Indications of Radiation Therapy
• 4. Local recurrence
• 5. Ulcerating lesions
• 6. Brain metastasis
• 7. Bone metastasis

10

• II. Systemic Treatment
• A. Cytotoxic chemotherapy
• B. Hormonal therapy

11

• Early Breast Cancer Trialist Collaborative Group
  (EBCTCG)
• confirmed that Tamoxifen
• and polychemotherapy
• reduced both recurrence and
• 10-year mortality
• Lancet 1992

12

• IS BREAST CANCER
• CURABLE?
• Yes
• No

13

• Prognostic Factors For Recurrence
• 1. Age
• 2. Cancer Stage at the time of
• initial diagnosis
• (Stage III gt II gt I )
• 3. Treatment given after surgery
• (adjuvant therapy)

14

• Chance for Cure rises after
• 5 to 10 years of no recurrence.
• Cure cannot be absolutely
• guaranteed.

15

• For Advanced or Metastatic Breast Cancer
• Cure is not possible
• Disease control may be achieved with the use
  of
• chemotherapy or hormonal therapy

16

• Risk Factors of Dying from
• Breast Cancer
• 1. Extent of metastasis
• 2. Co-morbid illnesses

17

• Surveillance
• Critical period is the 1st 3 years
• Requires follow-up every 3
• months

18

• Symptoms warranting further investigation
• chronic cough
• difficulty in breathing
• bone pains
• persistent headache
• abdominal enlargement /or
• pain