Breast Cancer

1. Diagnostic tests

1.1. CBE/ SBE Mammogram Breast ultrasound Needle (FNA or core needle) or excisional biopsy; sentinel lymph node biopsy MRI/CT chest/abdomen Ductal lavage and nipple aspiration

2. signs/symptoms

2.1. Lump or mass in breast (non-tender & firm; most often in outer/upper quadrant, fixed to skin & irregular shape/poorly defined).Usually painless (except late in disease) Swelling/lymphedema of affected arm Nipple discharge (clear or bloody) redness or scaling of breast or nipple Dimpling of breast

3. Treatments

3.1. Surgery Lumpectomy/quadrectomy mastectomy Prophylactic mastectomy Chemotherapy Radiation Therapy Hormone Therapy LH-RH antagonist (Lupron) Selective estrogen-receptor modulators Tamoxifen

4. pathophysiology

4.1. Unregulated growth of malignant abnormal cells in the breast tissue

5. causes and risk factors

5.1. Age/ gender Family history/genetic link BRCA1 or BRCA2 gene mutation Hormonal influences/long-term use of HRT Early menarche, late menopause Previous cancer of uterus, ovaries, breast, colon High dose radiation exposure to chest

6. prevalence

6.1. 1 in 8 women will develop breast cancer in lifetime Incidence rises after age 40 yrs <5% before age 40 yrs