BREAST CANCER

A   65-year-old woman   visits  the gynecologist    with    a   solid   2   cm  mass    in  the

upper   outer   quadrant    of  the left    breast. A   biopsy  of  the lesion  is  done,   which

is  consistent  with    “infiltrating   ductal  breast  cancer.”

Breast cancer continues to be the most common cancer diagnosed in women of
western industrialized countries. In 2018, an estimated 266,00 new cases of
invasive breast cancer are expected to be diagnosed in women in the United
States, along with 64,000 new cases of non-invasive (in situ) breast cancer.

Management. The preferred treatment for most patients with stage I or II breast
cancer is considered to be breast-conserving therapy with a wide excision,
axillary lymph node dissection or sentinel lymph node biopsy, and radiotherapy.
Lymphatic mapping and sentinel lymph node biopsy are new procedures that
offer the ability to avoid axillary lymph node dissection and its associated
morbidity in patients with small primary tumors who are at low risk of axillary
node involvement, while still offering nodal staging information.

Prognostic Factors. Some of the key decisions in the current management of
primary breast cancer involve the need for prognostication. Prognostic factors
serve to identify those patients who might benefit from adjuvant therapy.

Lymph   node    status. This    is  important   in  determining cancer  staging and

treatment   options.    Axillary    lymph   node    status  is  the most    important   factor  in

the prognosis   of  patients    with    breast  cancer. As  the number  of  positive

axillary    lymph   nodes   increases,  survival    rate    decreases   and relapse rate