breast cancer
| Headline | |
|---|---|
| Etiology | DCIS (more common with screening); invasive ductal carcinoma. |
| Epidemiology | Risk factors: - age - FHx (BRCA1 mutations) - uninterrupted oestrogen exposure (i.e. nulliparity, early menarche/late menopause, not breastfeeding, COCP, HRT) - exposure to radiation (e.g. radiotherapy for lymphoma) |
| Clinical presentation | skin changes e.g. peau d’orange, nipple changes, breast lump; Paget's disease |
| Pathogenesis | |
| Diagnostic investigations | Triple assessment is standard. |
| Management | WLE, mastectomy ± reconstruction + sentinel node biopsy • RT after WLE decreases risk of recurrence • Axillary RT if LN +ve • adjuvant chemotherapy • ER/PR +ve (60% of cancers) → oestrogen receptor blocker (tamoxifen) (⚠ uterine cancer) OR anastrozole if post-menopausal • ↑ risk mets with ↑ size |
| Prevention | NHS Breast Screening |