Breast Cancer 2024 Presentation PDF

Presented by Jonathan Breast Brack Date: 15/11/24 BREAST Jonathan Brack Learning outcomes Anatomy of the breast revision Epidemiology and aetiology of breast cancer Breast cancer signs, symptoms and clinical imaging Anatomy Revision Taken from: Mammography | Radiology Key Sear...

Presented by Jonathan Breast Brack Date: 15/11/24 BREAST Jonathan Brack Learning outcomes Anatomy of the breast revision Epidemiology and aetiology of breast cancer Breast cancer signs, symptoms and clinical imaging Anatomy Revision Taken from: Mammography | Radiology Key Searched 14/11/2024 Breast Cancer Prevalenc e Breast cancer statistics | Cancer Research UK. Searched 14/11/2024 Breast cancer figures Around 55,000 women and 370 men are diagnosed with breast cancer every year in the UK. In England, every year around 46,000 people are diagnosed with breast cancer. In Scotland, every year around 4,700 people are diagnosed with breast cancer. In Wales, every year around 2,800 people are diagnosed with breast cancer. In Northern Ireland, every year around 1,500 people are diagnosed with breast cancer. A further 7,000 people are diagnosed with DCIS (ductal carcinoma in situ), an early form of breast cancer, in the UK every year. One in seven women in the UK will develop breast cancer in their lifetime Stats continued Survival rate have 5 -year survival doubled in the UK rate of 85% in the last 40 years An estimated 600,000 people Results of early are alive in the UK detection and after a diagnosis better treatment of breast cancer. options. This is predicted to rise to 1.2 million in 2030  Familial breast cancer - Criteria for identifying women at substantial increased risk The following categories identify women who have three or more times the population risk of developing breast cancer: A woman who has: One first degree relative with bilateral breast cancer or breast and ovarian cancer or One first degree relative with breast cancer diagnosed under the age of 40 years or one first degree male relative with breast cancer diagnosed at any age or Two first or second degree relatives with breast cancer diagnosed under the age of 60 years or ovarian cancer at any age on the same side of the family or Three first or second relatives with breast and ovarian cancer on the same side of the family First degree relative is mother, sister, or daughter. Second degree female relative is grandmother, granddaughter, aunt, or niece Criteria for identifying women at very high risk in whom gene testing might be appropriate Families with four or more relatives affected with either breast or ovarian cancer in three generations and one alive affected relative Breast cancer signs, Symptoms Imaging  Overview : Breast cancer Referral process NICE guidance (NG12) has the following recommendations: Refer people using a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer if they are: - aged 30 and over and have an unexplained breast lump with or without pain or - aged 50 and over with any of the following symptoms in one nipple only: o discharge o retraction o other changes of concern. [new 2015] Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for breast cancer in people: - with skin changes that suggest breast cancer or - aged 30 and over with an unexplained lump in the axilla. [new 2015] Consider non-urgent referral in people aged under 30 with an unexplained breast lump with or without pain.  If a node spread pattern is known then the tumour is injected to track the Sentinel sentinel lymph node (SLN). node in A radioisope or blue dye is used to inject breast the tumour and follow the lymph cancer pathway. The SLN is examined for cancer cells. The area is then scanned or examined in an attempt to establish if key nodes are involved with tumour, if positive the nodes must be removed. Biopsy of lymph node Sampling a node Diagnosis Infection or tumour? Histology of cells Sentinel node biopsy  Diagnostic tools If lymph node pattern is predictable then not all nodes need be removed (clearance or dissection). Biopsy of a sentinel node can avoid unnecessary surgery for the patient. Main Types of Breast Cancer Invasive breast cancer Invasive ductal breast Ductal carcinoma in cancer HER2 positive breast Invasive lobular breast situ (DCIS) cancer cancer Inflammatory breast cancer Paget’s disease of the breast Triple negative breast cancer Rarer types: medullary breast cancer, Lobular carcinoma in mucinous breast situ (LCIS) cancer, tubular breast cancer, malignant phyllodes tumour  Breast Cancer Those with "oestrogen receptors" should respond to Depending on stage of hormone therapies such as One or a combination of the disease, a variety of tamoxifen; those with a "Her2 above is used treatments can be offered: receptor" can be treated with Herceptin hormonal, chemotherapy, surgery and radiation therapy Staging and grading BREAST CANCER LINK - Staging Breast cancers can be: low grade – grade 1 (slow growing) intermediate grade – grade 2 high grade – grade 3 (faster growing) Breast Cancer Example:T1 or T2 tumours can be treated with WLE followed by radiotherapy to Example: T4 inflammatory the breast or mastectomy - cancer is treated with depending on the site & size primary chemotherapy and of tumour, histological type, radiotherapy grade and extent of in-situ change and size of the breast Breast cancer TNM TNM staging RATIONALE RT is given for primary carcinoma of the breast to reduce the risk of loco-regional recurrence  Core members of the MDT Designated breast surgeon(s) Radiologist MDT Histopathologist Oncologist members Breast care nurse(s) MDT Co-ordinator Extended member of the MDT for Breast may include: Plastic and reconstructive surgeon Data management personnel Research nurse(s) Clinical psychologist Palliative care team