We confirm the diagnosis of breast cancer by triple assessment- clinical examination, biopsy and mammography. Once the diagnosis is in our hands we stage the disease to evaluate the clinical stage – that makes a difference in the choice of the treatment.
Personally i prefer to get a Whole body PET CT scan to stage breast cancer. There are instituts that prefer sonography of the abdomen, xray chest and bone scan if needed or clinically doubtful. Along with scanning , immunohistochemistry of the biopsy sample. It helps to see the aggressiveness of the tumour and also helps in the planning of treatment.
After staging of the disease treatment of breast cancer involves either one or multiple modalities of treatment including surgery, chemotherapy, radiation therapy and hormonal therapy.
Surgery involves either removal of the whole breast called mastectomy with removal of the axillary Lymph nodes or a wide local excision of the breast lump along with sampling of axillary nodes. A frozen section to confirm the margins and to identify involvement modes is preferable and is encouraged.
With the advancement of technology plastic surgery in forms of implants and flaps reconstruction of breast has become more available leading to better cosmetic results and in turn better complacency to surgical treatment. Patients even when undergoing complete breast removal can be offered good reconstruction if medically permissible and of right age
Chemotherapy schedules vary depend on the age and general condition of the patient as well as the stage and the IHC reports.
All patients don’t need it and those who need have good tolerance to the new generation drugs with good quality of life. Radiation treatment also has evolved over the last 2 decades or so with more advanced, more appropriate treatment strategies. This leads to very good quality of life with very acceptable techniques.
Patients who are hormone sensitive benefit from hormone therapy. And that is a very good answer to many patients who would otherwise be difficult to control.
Last few unminced words – we are rapidly seeing a explosion of breast cancer cases
. just with awareness to get a check up timely, self breast examination, and good treatment protocols leads to Much much better survivals in these patients.