1. Gaurav Agarwal / Jul 2008 SGPGIMS, Lucknow, India Why is SGPGIMS Lucknow an ideal Hospital for state-of-the-art treatment of Breast Cancer

2. Gaurav Agarwal / Jul 2008 Breast Cancer is best treated in a Multi Disciplinary Manner by a team of experts. All components of such an expert team are available under one roof at SGPGIMS Lucknow Radiation Oncologist Pathologist Radiologist Breast Surgeon SGPGIMSSGPGIMS Medical Oncologist Nuclear Medicine

3. Gaurav Agarwal / Jul 2008 How is Breast Cancer Managed at SGPGIMS Lucknow, and at major eminent centers around the world Suspected Breast Cancer Confirmation of Diagnosis Staging Treatment Follow-up Identify Recurrence Secondary treatment Complications Surgery, CTx, RTx, HTx Early OperableLocally Advanced Metastatic

4. Gaurav Agarwal / Jul 2008 Curable In-curable Potentially Curable Early Operable Breast Cancer Staging Breast Cancer is an important initial step in deciding appropriate treatment for an individual patient Patients are staged into three major groups according to stage of disease. The approach to treatment and expected outcomes are very different in these three groups

5. Gaurav Agarwal / Jul 2008 What are the Treatment Modalities used for treatment of breast cancer For Loco-regional control- i.e. treating the primary cancer in breast and regional disease in lymphatic basin of axilla (arm-pit) Surgery Radiation therapy For Systemic control- i.e. for control of invisible (in early stage cancers) or evident (late stage) disease outside the breast and arm-pit Cyto-toxic chemotherapy Hormonal therapy Immuno-therapy/ other biologicals Almost all modalities are required in almost all patients, though with different intention, and in different sequence

6. Gaurav Agarwal / Jul 2008 What is an appropriate sequence of various components of Breast cancer Treatment: this varies according to stage groups Biopsy: Cytologic/ histologic Confirmation Staging Early Operable Operation Adjuvant Tt- chemotherapy, radiation, hormone Follow-up Locally Advanced Neo-adjuvant Chemotherapy Surgical Tt Adjuvant Tt Follow-up Metastatic Primary/ salvage Systemic Tt ?Surgical Tt Follow-up