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Breast cancer: Difference between revisions
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<section begin="oncology" />'''Breast cancer''' (BC) is the most common malignancy in women and it’s the second most common cause of cancer mortality. The condition is related to increased oestrogen. When we talk about breast cancer we can mean either non-invasive or invasive carcinoma. These tumors develop from different parts of the terminal duct lobular unit (TDLU). They most frequently affect the upper outer quadrant of the breast. | <section begin="surgery" /><section begin="oncology" />'''Breast cancer''' (BC) is the most common malignancy in women and it’s the second most common cause of cancer mortality. The condition is related to increased oestrogen. When we talk about breast cancer we can mean either non-invasive or invasive carcinoma. These tumors develop from different parts of the terminal duct lobular unit (TDLU). They most frequently affect the upper outer quadrant of the breast. | ||
Breast cancer is most common in older, post-menopausal women. Cancers in younger women are commonly hereditary rather than sporadic. 90% of cases are sporadic and 10% are familial. Breast cancer in men is very rare but it does occur. | Breast cancer is most common in older, post-menopausal women. Cancers in younger women are commonly hereditary rather than sporadic. 90% of cases are sporadic and 10% are familial. Breast cancer in men is very rare but it does occur. | ||
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=== Invasive lobular carcinoma === | === Invasive lobular carcinoma === | ||
Invasive lobular carcinoma accounts for 5 – 10% of invasive carcinoma. It originates from a breast lobule. It occurs when LCIS invades past the basement membrane of the lobules. As these cells lack E-cadherin the tumor cells don’t form structures. The tumor cells often forms single rows with each other. Signet ring cells may be present. Almost all express hormone receptors, very few express HER2/NEU.<section end="oncology" /> | Invasive lobular carcinoma accounts for 5 – 10% of invasive carcinoma. It originates from a breast lobule. It occurs when LCIS invades past the basement membrane of the lobules. As these cells lack E-cadherin the tumor cells don’t form structures. The tumor cells often forms single rows with each other. Signet ring cells may be present. Almost all express hormone receptors, very few express HER2/NEU.<section end="surgery" /><section end="oncology" /> | ||
=== Other types of breast cancer === | === Other types of breast cancer === | ||
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Of the familial cases, mutations in [[BRCA|BRCA1]] and BRCA2 are most common. Germ-line mutations in BRCA1 or BRCA2 is found in one third of cases with hereditary breast cancer. They’re rarely mutated in sporadic cases of cancer. These proteins are tumor suppressors involved in DNA repair. | Of the familial cases, mutations in [[BRCA|BRCA1]] and BRCA2 are most common. Germ-line mutations in BRCA1 or BRCA2 is found in one third of cases with hereditary breast cancer. They’re rarely mutated in sporadic cases of cancer. These proteins are tumor suppressors involved in DNA repair. | ||
<section begin="surgery" /> | |||
=== Metastasis === | === Metastasis === | ||
Breast cancer most commonly metastasizes to the lungs, skeleton and liver. | Breast cancer most commonly metastasizes to the lungs, skeleton and liver. | ||
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=== Surgical therapy === | === Surgical therapy === | ||
Surgical therapy may be breast-conserving surgery or mastectomy. Breast-conserving surgery removes the mass and as little of the breast as possible and preserves the rest of the breast. Breast-conserving surgery should always be followed up by radiation therapy. Staging of axillary lymph nodes must always be performed during surgery. Breast reconstruction may be performed later for cosmetic purposes. LCIS requires no surgery if histology determines that it’s of the “classic” type. Nonclassic LCIS requires surgery. | Surgical therapy may be breast-conserving surgery or mastectomy. Breast-conserving surgery removes the mass and as little of the breast as possible and preserves the rest of the breast. Breast-conserving surgery should always be followed up by radiation therapy. Staging of axillary lymph nodes must always be performed during surgery. Breast reconstruction may be performed later for cosmetic purposes. LCIS requires no surgery if histology determines that it’s of the “classic” type. Nonclassic LCIS requires surgery. | ||
<section end="surgery" /> | |||
=== Chemotherapy === | === Chemotherapy === | ||
Chemotherapy usually involves anthracyclines and taxanes. | Chemotherapy usually involves anthracyclines and taxanes. | ||