2. Breast Cancer: The Profile Ma. Belen E. Tamayo,M.D. Medical Oncologist Makati Medical Center The Medical City

3. Breast Cancer leading cause of cancer and cancer death among females worldwide estimated to affect 1 in 10 females during her lifetime

4. Risk Factors: 1. Female gender 2. Hormonal factors 3. Family history particularly 1st degree relatives (mother, sisters) 4. Previous breast cancer 5. (+)BRCA-1, BRCA-2 gene

5. Clinical Presentation: lump in the breast skin dimpling skin retraction nipple discharge ulcerating breast mass pain in the breast

6. Diagnosis: tissue biopsy (excision or FNA) mammography scintimammography MRI

7. Management Depends on Several Factors: 1. Stage of the disease 2. Age 3. Menopausal status 4. Estrogen/Progesterone Receptors 5. Concomitant illness

8. Management : I. Local Treatment A. Surgery 1.Breast-conservation surg + ALND + RT 2.Modified radical mastectomy

9. B. Radiation Therapy Cobalt Linear Accelerator Indications: 1. Node positive tumors (II,III) 2. (+) margins of resection 3. As part of breast conservation treatment

10. Indications of Radiation Therapy: 4. Local recurrence 5. Ulcerating lesions 6. Brain metastasis 7. Bone metastasis

11. II. Systemic Treatment A. Cytotoxic chemotherapy B. Hormonal therapy

12. Early Breast Cancer Trialist Collaborative Group (EBCTCG) confirmed that Tamoxifen and polychemotherapy reduced both recurrence and 10-year mortality Lancet 1992

13. IS BREAST CANCER CURABLE? Yes No

14. Prognostic Factors For Recurrence: 1. Age 2. Cancer Stage at the time of initial diagnosis (Stage III > II > I ) 3. Treatment given after surgery (adjuvant therapy)

15. Chance for Cure rises after 5 to 10 years of no recurrence. Cure cannot be absolutely guaranteed.

16. For Advanced or Metastatic Breast Cancer: Cure is not possible Disease control may be achieved with the use of chemotherapy or hormonal therapy

17. Risk Factors of Dying from Breast Cancer: 1. Extent of metastasis 2. Co-morbid illnesses

18. Surveillance Critical period is the 1st 3 years Requires follow-up every 3 months

19. Symptoms warranting further investigation: chronic cough difficulty in breathing bone pains persistent headache abdominal enlargement &/or pain