Posted: 23 Dec 2009 08:05 AM PST

Breast Cancer Detection

Just imagine that you went to your doctor for your annual checkup. She checked you completely, and then decided that you needed a mammogram. Your first horrified thought is, "Oh no, why is she asking for an x-ray of my breast? Can it be breast cancer?" But one need not worry. Breast cancer is curable, like any other cancer, if detected in time. So you would want to look for the early symptoms of cancer, which might have been detected during your monthly breast self-examination in which you looked carefully at your breasts to detect any unusual symptoms.

This mere thought of one suffering from breast cancer can be terrifying in itself. It means future surgery, possible death, and loss of one's sexual allure. This terrifying image and dim future prospect of this cancerous form is the reason why many women overlook the possibility of their suffering from breast cancer. And that is the reason why many women of the age group 20 -- 40 do not go for a possible cure, even though the symptoms are present.

Symptoms of breast cancer

Your doctor may have recommended a mammogram for possible cancer detection, because she (or you), noticed these symptoms and changes in the breast.

Did you suddenly find a hard yet painless lump in the breast tissue? Breast cancer may possibly not show any symptoms overtly and you might find the lump to be really small to be detected by your fingers. That was while you are doing a self-examination of your breasts by yourself before you went to the doctor for possible ratification of your suspicions. Besides, it is not paining you, is it? It is only a mammogram, which can detect abnormal areas present in the breast. and this is going to lead to future and further testing. These lumps in the breast can be hard, yet painless; on the other hand, you might notice that the lumps are rounded, soft and tender. Whatever forms a lump takes, it needs to be checked up thoroughly and immediately by the doctor. You definitely do not want to disregard the warning signs of breast cancer.

Now, here are some common symptoms of breast cancer.

Did you notice a lumpy growth in your breast or under the armpits?
Do you find some swelling, which was not explained in the breast area?
Did you notice that the color of the skin around the nipples or on the breast had changed to red? Did you notice some abnormal puffiness and scaliness in the region around your nipple?
Did you find an unexplained lump under the underarm?
Do you find your breasts or your nipples paining with no perceptible cause or reason?

You might also be a little worried about some particular area of your breast swelling up. You may have also noticed some slight irritation in the skin and a discharge coming out from the nipple. These are all common symptoms, which may presage the initial presence of cancer. Other symptoms include pain in the nipple and in the breast area, and the nipple turning inwards.

Go and see a doctor immediately if you find the area around the nipple growing thick and red. Some patients also noticed scaliness of the skin in the nipple area. They went to the doctor immediately and got a mammogram done. They are now being treated successfully with the help of radiotherapy and chemotherapy.

Treatment of Breast Cancer

Breast cancer, like any other cancer is treatable, if caught in the initial stages. So do not hesitate to go to your doctor with your suspicions of possible cancer. She is going to diagnose the symptoms, do further tests like mammographic tests and perhaps a breast biopsy. After that, she is going to recommend that treatment which is most effective for your particular case.

Five Filters featured article: Chilcot Inquiry. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

Staging Breast Cancer

Posted: 23 Dec 2009 08:05 AM PST

Knowing the stage of your breast cancer helps your medical team determine how big the cancer is and if it has spread. This helps them guide your therapy and provide reliable prognostic information.

In general, staging is done following your surgery, either after lumpectomy or mastectomy. It usually includes evaluation of the lymph nodes in your armpit (axillary lymph nodes), and possibly other radiology tests and blood work.

All breast cancers are staged using a system defined by the American Joint Committee on Cancer. The system was most recently modified in 2002, and its classifications are based on what's called a "TNM system." TNM refers to tumor size (T), number of lymph nodes involved (N), and whether your cancer has metastasized (or spread) to other parts of your body (M).

The following is an overview of the TNM system*.

T: The size of the cancer.

T0: No cancer is present.

Tis: Non-invasive cancer, also known as carcinoma in situ, is present.

T1: Invasive cancer measuring 2 centimeters or smaller is present. This is further sub-divided into four groups:

Tmic: microinvasive cancer, meaning the invasive cancer is 1 millimeter or smaller.

T1a: the invasive cancer measures greater than 1 millimeter but not greater than 5 millimeters.

T1b: the invasive cancer measures greater than 5 millimeters but not greater than 1 centimeter.

T1c: the invasive cancer measures greater than 1 centimeter but not greater than 2 centimeters.

T2: Invasive cancer is present, measuring greater than 2 centimeters but not greater than 5 centimeters.

T3: Invasive cancer is present, measuring greater than 5 centimeters.

T4: Invasive cancer is invading the chest wall or skin; also includes inflammatory cancer.

N: The number of lymph nodes involved by cancer.

N0: No cancer found in nodes. In 2002, an addition was made for the diagnosis of isolated tumor cells (ITCs):

N0i+: Cells found in the node measuring 0.2 millimeters or less, found either on routine pathology or using immunohistochemistry.

N1: Cancer is present in 1-3 nodes in the armpit area (also known as axillary lymph nodes).

N1mic: The cancer present in the node measures greater than 0.2 millimeters but not greater than 2 millimeters. This is also known as a micrometastasis.

N2: Cancer is present in 4-9 axillary nodes.

N3: Cancer is present in 10 or more axillary nodes.

M: The presence or absence of distant metastases.

M0: No distant metastases are present.

M1: Distant metastases are present.

Once you know your T, N, and M status, you can determine your breast cancer stage as follows:

Stage 0: Tis, N0, M0

Stage I: T1, N0, M0.

Stage IIA: T0/T1 with N1, M0 or T2, N0, M0

Stage IIB: T2, N1, M0 or T3, N0, M0

Stage IIIA: T0/T1/T2 with N2, M0 or T3 with N1 or N2 and M0

Stage IIIB: T4 with N0/N1/N2, M0

Stage IIIC: Any T with N3, M0

Stage IV: Any T, any N with M1

Five Filters featured article: Chilcot Inquiry. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

Ductal Carcinoma in Situ Vs Lobular Carcinoma in Situ

Posted: 23 Dec 2009 07:43 AM PST

One of the more confusing areas in breast pathology for patients is the difference between ductal carcinoma in situ and lobular carcinoma in situ (DCIS vs. LCIS). DCIS arises in the larger ducts of the breast and LCIS arises within the lobules of the breast. However, the ducts and lobules are connected which means that DCIS may travel into the lobules and LCIS may travel up the ducts. For this reason, pathologists rely on the type of cells and pattern of growth to determine the diagnosis of DCIS vs. LCIS. Only a pathologist can make this distinction. In some cases, both DCIS and LCIS are present in the same biopsy.

DCIS and LCIS both increase a patient's relative risk for developing invasive breast cancer and that risk applies to both breasts. However, DCIS is also thought to be a "precursor" to invasive carcinoma based upon numerous research studies. This is why your surgeon tries to remove all areas of DCIS from your breast and why many patients subsequently receive radiation therapy to that breast.

LCIS, on the other hand, has not traditionally been considered to be a "precursor" to invasive carcinoma, therefore complete removal of LCIS and radiation therapy is not required. There is emerging data that may change this way of thinking, but the current standard of care is to treat LCIS and DCIS differently. One exception to this may be pleomorphic LCIS which will be discussed later.

Ductal Carcinoma In Situ (DCIS)
DCIS is a complex diagnosis. If you are diagnosed, it's important to know what grade of DCIS your pathologist has assigned (low, intermediate, or high), and whether or not necrosis (dead cells) are present.

If you have a diagnosis of DCIS on a core needle biopsy, you need to have a surgical procedure to try and remove all of the DCIS with adequate margins. If you have had a lumpectomy/partial mastectomy with a diagnosis of DCIS, be sure that the pathology report includes the following: the size of the DCIS, the grade, the presence or absence of necrosis, and the distance the DCIS is from the surgical margins. All of these factors influence what type of treatment you should receive next. Possible therapies include one or more of the following: additional surgery, radiation therapy, or endocrine therapy.

Lobular Carcinoma In Situ (LCIS)
Lobular carcinoma in situ (LCIS) refers to a neoplastic proliferation of cells that fill up the lobules in your breast and may extend into the duct system.

Unlike DCIS, LCIS is generally not graded by most pathologists. An exception is a recently described entity called "pleomorphic LCIS." Pleomorphic LCIS refers to an in situ carcinoma with the characteristic features of LCIS, plus more atypical cells and often necrosis (dead cells). Pleomorphic LCIS can be difficult to distinguish from DCIS in many cases, but a special stain called e-cadherin can be used to help your pathologist make the distinction.

Treatment of LCIS vs. Pleomorphic LCIS
If you have a diagnosis of LCIS on a core needle biopsy, generally your surgeon will want to perform surgery to excise the area of concern, although this is somewhat controversial in the medical literature. If you have a diagnosis of only LCIS on your lumpectomy/partial mastectomy, there is no need to worry about clear margins and radiation therapy is not the standard of treatment. Unlike classic LCIS, there is no uniformly accepted standard treatment for pleomorphic LCIS, although many medical teams choose to treat it like DCIS.

Once you have a diagnosis of LCIS, because you are now at increased risk for developing invasive carcinoma, your medical team may recommend endocrine therapy.

Five Filters featured article: Chilcot Inquiry. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

Breast Cancer

Thursday, December 24, 2009

“What Are the Early Warning Signs of Breast Cancer?” plus 2 more

“What Are the Early Warning Signs of Breast Cancer?” plus 2 more

No comments:

Post a Comment