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Breast cancer is the most common malignancy among women worldwide and represents a significant clinical challenge. This overview provides essential information for clinicians regarding the pathophysiology, diagnosis, treatment, and management of breast cancer.
Breast cancer arises from the epithelial cells lining the ducts or lobules of the breast. The transformation of these cells involves multiple genetic mutations that lead to uncontrolled cell proliferation. Key factors involved in the development of breast cancer include
Risk Factor | Description | Effect on Breast Cancer Risk |
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Age | Breast cancer risk increases with age, particularly after age 50. | Increases risk |
Gender | Breast cancer is much more common in women than in men. | Increases risk |
Family History | A history of breast cancer in close relatives, especially a mother, sister, or daughter, increases the risk. | Increases risk |
Genetic Mutations | Mutations in genes such as BRCA1 and BRCA2 significantly increase the risk of breast cancer. | Increases risk |
Early Menarche and Late Menopause | Women who start menstruating early (before age 12) or go through menopause late (after age 55) have a higher risk due to longer exposure to estrogen. | Increases risk |
Hormone Replacement Therapy (HRT) | Long-term use of combined estrogen-progestin hormone therapy after menopause increases breast cancer risk. | Increases risk |
Obesity | Being overweight or obese, especially after menopause, increases the risk due to higher levels of estrogen produced by fat tissue. | Increases risk |
Alcohol Consumption | Regular alcohol consumption is linked to an increased risk of breast cancer, particularly with higher amounts of alcohol intake. | Increases risk |
Physical Activity | Regular exercise can help lower the risk of breast cancer by maintaining a healthy weight and hormone balance. | Decreases risk |
Breastfeeding | Breastfeeding reduces the risk of breast cancer, especially if continued for 1.5 to 2 years. | Decreases risk |
Childbearing | Having children, especially before the age of 30, can lower the risk of breast cancer. | Decreases risk |
Diet | A healthy diet rich in vegetables, fruits, and whole grains, and low in processed foods, can reduce cancer risk. | Decreases risk |
Avoiding Tobacco | Not smoking or quitting smoking reduces the risk of breast and other cancers. | Decreases risk |
The clinical presentation of breast cancer can vary widely. Common symptoms and signs include:
Adjuvant radiation therapy is commonly used after breast-conserving surgery to reduce the risk of local recurrence. It may also be used in advanced cases for palliation.
Systemic therapy includes chemotherapy, hormone therapy, and targeted therapy. The choice of therapy is guided by the tumour's receptor status and other molecular characteristics:
The prognosis of breast cancer depends on several factors, including the stage at diagnosis, tumour grade, hormone receptor status, and HER2 status. Early detection and treatment significantly improve outcomes, with 5-year survival rates exceeding 90% for localized breast cancer.
Long-term follow-up is essential for detecting recurrences and managing the side effects of treatment. Follow-up care includes regular physical examinations, imaging studies, and monitoring for late effects of therapy, such as cardiotoxicity from chemotherapy or radiation.
Breast cancer management requires a multidisciplinary approach involving surgery, medical oncology, radiation oncology, and supportive care. Staying updated on the latest guidelines and advancements in breast cancer treatment is crucial for providing optimal patient care.