Breast cancer

This two words are one of the most scary words a woman may hear or pronounce. Breast cancer is the death cause most often encountered among women . Breast cancer is like a thief that attacks you in the night without any warning because it may be asymptomatic .
It is firstly detected like an abnormality on a mammogram before it is felt by the patient.

When symptoms like breast pain, nipple discharge, breast lumps, and cancer is taken into consideration then, the modalities to set a diagnostic are : biopsy, aspiration, imaging. Also is recommended physical examination that should include inspection and palpation. In evaluating breast lumps, mammography can be performed but is useful only for women after 35 years old. The fine-needle aspiration is used to aspirate a suspected cyst that was palpated . If nonbloody fluid is obtained, it can be discarded because cancer is not found in nonbloody cyst fluid. If bloody fluid is found than it has to be checked in the lab. The core needle biopsy is used to evaluate nonpalpable breast masses found only on mammography.

After the investigations if there is no cancer than the treatment is specific for every symptom. For instance if the breast pain is caused by infections than antibiotics are required. Surgical drainage can be used for hidradenitis or abscesses. Nipple discharge can be caused by some pills and then the medication should be changed. It can also be caused by pituitary adenomas and medical or surgical therapy should take place.

Once breast cancer is discovered, the treatment will include a team of doctors and oncologists. If the cancer is tracked in its early stage then the treatment will include local therapy with or without radiation therapy. The tumor will be removed with a mastectomy or with breast-conserving surgery.. The radiation therapy is included to prevent the recurrence . When in forms of metastatic disease the cancer does recur the death rates are high. The treatment (chemotherapy, biologic therapies) may prolong life but it is no miracle making. The results of chemotherapy are more visible in the cases of young women . Chemotherapy, combined with trastuzumab is reducing the chances for recurrence in patients with Her2 over expressing breast cancer. Her2 is a protein over expressed in one fourth of breast cancers.

In some evolved countries the death rates have decreased because women are educated to check their breasts and when they feel something strange, or some pain they address immediately a doctor. The prognostic factors of this condition include : the tumor size and stage, the age of the patient, histological subtypes , response to neoadjuvant therapy.

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