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