Diagnosis and Treatment

DIAGNOSIS 

It is very important for you that if you have found anything abnormal or if there is any noticeable change since the last examination, you must consult your doctor without any delay. You are not the one who make the diagnosis, your role is only to detect any of the changes during self examination. A diagnosis of breast cancer is terrifying fear of un known. From disease diagnosis and during the course of treatment you can expect to deal with the following physicians, who will work with you in planning various phases of your treatment.

1. Gynecologist or internist: Orders breast screening test, primary care given.
2. General Surgeon: Performs the biopsy and mastectomy.
3. Pathologist: Determines the degree of malignancy by study of the tumor.
4. Medical Oncologist: Administers chemotherapy.
5. Radiation Oncologist: Administers radiation therapy.
6. Plastic Surgeon: Performs the breast reconstruction.

Mammography

X-ray mammography is the only breast imaging technique suitable for screening. It is the most reliable method to detect Breast Cancer & it can show a very early cancer. It can differentiate between cysts, fibro adenoma, other lumps and most forms of malignant disease.

The standard mammography examination includes two X-rays of each breast, one from above and one from side. To get the best X-ray image, the breast is flattened between two plastic plates. The compression may be un comfortable but it is not harmful to the breast and is usually not painful. Scheduling the mammogram after the menstrual period, when the breast are less tender will reduce the discomfort.

With the reference of ( American Cancer Society Guidelines)First baseline mammogram should be done by age 40. After age 40 , mammogram every 1.2 years until age 50. After age 50 , mammograms done annually. Other factors, such as strong family history or previous breast disease may indicate the need for mammography at an early age or of frequent basis.

Ultrasonography

This technique is used to confirm the presence or absence of a mass and to tell the difference between solid masses and cysts. Ultrasonography commonly used as Ultrasound , uses high frequency sound waves to scan the tissue of the breast. It sends sound waves through the breast , and when some thing solid gets in their way , they bounce back. The entire process is viewed on a video screen, and photographs are made to significant views.

Biopsy

If the doctor suspects that a mass is breast cancer, he or she may perform a biopsy. In a biopsy, a piece of tissue is removed and examined under a microscope. Types of biopsy are:

Surgical Biopsy: It is a painless , valuable , out patient diagnostic technique in which fluid is drawn from the breast lump with a fine needle. The specimen forwarded to an expert pathologist for further investigation.

Excisional Biopsy: It is still the predominant method of confirming a suspicion of cancer. It involves a patient having a general or local anesthetic, and a small incision being made in the breast so that a portion of tissues or even a whole lump can be removed and examined under the microscope.

Stages

The term "early breast cancer" refers to stages of breast cancer labeled 0, I,II, III & IV.

Stage 0: Cancer cells are present in either the lining of a breast lobule or a duct, but they have not spread to surrounding fatty tissue. This stage is also called duct al carcinoma in situ or DCIS.

Stage I: Cancer has spread from the lobules or ducts to the nearby tissue in the breast. At this stage and beyond, breast cancer is considered to be invasive. The tumor is 2 cm or less in diameter (approximately 1 inches or less); the lymph nodes are not involved.

Stage II: Cancer has spread from the lobules or ducts to nearby tissue in the breast. In this stage
the tumor can range from 2cm to greater than cm in diameter (approximately 1•2 inches); sometimes the lymph nodes may be involved. A recurrence is a return of breast cancer. After surgery for early breast cancer, adjuvant, or additional, therapy may be given to reduce the chance of a recurrence.
The term "advanced stages of breast cancer" refers to stages of breast cancer labeled III and IV.

Stage III: Known as locally advanced cancer; tumor may be larger than 5 cm (2 inches) in diameter, and the cancer may or may not have spread to lymph nodes or other tissues near the breast.

Stage IV: Known as meta static; cancer has spread from breast and lymph nodes under the arm to other parts of the body, such as bone, liver, lung, or brain.

TREATMENT

There are many different types of breast cancer, so the treatment is not the same for every woman. The treatment of breast cancer is determined by many factors such as:

1. Tumor stage
2. Tumor type
3. Tumor characteristics
4. Patient’s general health