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Breast Cancer

Renata Gazzi, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Malignant neoplasm of cells native to the breast—epithelial, glandular, or stroma

  • Types: DCIS, infiltrating ductal carcinoma, infiltrating lobular carcinoma, Paget disease, phyllodes ...

DIAGNOSIS

HISTORY

  • Painless lump in breast or axilla

  • Breast pain, heaviness

  • Swelling, thickening, redness, or dimpling of the skin

  • Nipple discharge (bloody), erosion, or retraction

PHYSICAL EXAM

  • Visualize br...

TREATMENT

MEDICATION

  • Secondary prevention

    • ASA use at least once per week may be associated with as much as a 50% reduction in death from BC; chemoprevention/hormone therapy for patients age ≥35 years

    • R...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Every 4 to 6 months for 5 years, then annually

  • No evidence to support the use of routine CBC, LFTs, “tumor markers,” bone scan, CXR, liver ultrasound, CT scans, MR...

REFERENCES

1
1 American Cancer Society. Breast Cancer Facts & Figures 2015–2016. Atlanta, GA: American Cancer Society; 2015. http://www.cancer.org. Accessed September 4, 2017.
2
2 National Comprehens...

ADDITIONAL READING

  • Giuliano AE, Hunt KK, Ballman KV, et al. Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial...

CODES

ICD10

  • C50.919 Malignant neoplasm of unsp site of unspecified female breast

  • D05.90 Unspecified type of carcinoma in situ of unspecified breast

  • Z12.31 Encntr screen mammogram for malignant neoplasm o...

CLINICAL PEARLS

  • BC is most common CA death in U.S. women; lifetime risk of 1 in 8

  • High alcohol use, high body mass index (BMI), and physical inactivity are modifiable risk factors.

  • Pursue/refer all abno...

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