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Junko Ozao-Choy Armando E. Giuliano
Breast cancer accounts for one-third of cancers in women. The risk of breast cancer increases with a positive family history and the use of hormone therapy. Breast cancer may be either in situ (ductal carcinoma in situ or lobular carcinoma in situ) or invasive (infiltrating ductal carcinoma, infiltrating lobular carcinoma).
The standard screening modalities for detection of breast cancer include yearly mammography and physical examination.
Tissue diagnosis is achieved using fine-needle aspiration cytology (FNAC) or core needle biopsy (CNB). Open biopsy is performed if FNAC or CNB results are equivocal or discordant with the clinical findings.
The combination of segmental mastectomy (with negative surgical margins), axillary lymph node dissection, and postoperative radiation therapy has the same overall survival compared to modified radical mastectomy for the management of patients with stages I and II breast cancer.
Axillary lymph node status and the number of involved nodes are the most important prognostic indicators in primary breast cancer.
Sentinel lymph node dissection alone can replace axillary lymph node dissection if the sentinel lymph node is found to be negative on pathology.
Adjuvant systemic therapy prolongs survival and is recommended for women with a greater than 10% chance of relapse within 10 years.
Breast cancer accounts for approximately one-third of all cancers in women and is second only to lung cancer as the leading cause of cancer deaths among women. Breast cancer has the highest incidence rate of all cancers. According to statistics from the American Cancer Society (ACS), over 230,000 new cases of invasive breast cancer will be diagnosed in women during 2011 in the United States as well as over 55,000 patients of in situ cancers, with almost 40,000 women succumbing to the disease during the same period (1). Over the past 50 years, the incidence of breast cancer in the United States increased significantly; one in every seven women will develop the disease during her lifetime. Fortunately, the mortality rate has declined since 1990.