Read Also: Breast Cancer – Facts About Breast Cancer

Early detection: Mammography can detect breast cancer at an early stage when treatment may be more effective. Numerous studies have shown that early detection saves lives and increases treatment options. The recent declines in breast cancer mortality among women have been attributed to a combination of early detection and improvements in treatment.

Mammog-raphy is highly accurate but like most medical tests, it is not perfect. On average, mammography will detect about 80%-90% of breast cancers in women without symptoms. All suspicious lumps should be biopsied for a definitive diagnosis. Several recent studies have shown that magnetic resonance imaging appears to be more sensitive than mammography in detecting tumors in women with an inherited susceptibility to breast cancer.

Breast Cancer Treatment: Taking into account tumor size, stage, and other characteristics, as well as patient preference, treatment may involve lumpectomy (surgical removal of the tumor with clear margins) or mastectomy (surgical removal of the breast) with removal of some of the axillary (underarm) lymph nodes (to obtain accurate information on stage of disease).

It may also involve radiation therapy, chemotherapy, hormone therapy (tamoxifen, aromatase inhibitors), or targeted biologic therapy (trastuzumab). Monoclonal antibody immuno-therapy with trastuzumab (Herceptin®) is sometimes used in women whose cancer tests positive for HER2/neu, the protein that Herceptin® is directed against. Two or more methods are often used in combination.

Numerous studies have shown that, unless cancer has spread to the skin, chest wall, or distant organs, long-term survival rates after lumpectomy plus radiation therapy are similar to survival rates after mastectomy. To ascertain whether cancer has spread beyond the original tumor site, a relatively new technique called sentinel lymph node biopsy is reducing the need for full axillary lymph node dissection in women with early-stage breast cancer. Lymph nodes draining the tumor site are tested and only those nodes that are suspected to be cancerous are removed.

Sentinel lymph node biopsy is preferable to axillary lymph node dissection (removal of lymph nodes in the underarm area) because fewer lymph nodes are removed, so there is a lower risk for side effects such as lymphedema, a swelling of the arm that can be painful and disabling. Eligible women who elect to have sentinel lymph node biopsy should have their breast cancer surgery at a facility with a medical care team that is experienced with the technique.For women undergoing mastectomy, significant advances in reconstruction techniques provide several options for breast reconstruction, including the timing of the procedure (i.e., during mastectomy or in the time period following the procedure).

The exact percentage of mammographically detected ductal carcinoma in situ (DCIS) that would progress to invasive breast cancer without treatment is not known. However, data from mammography screening trials suggest that the majority of such cancers will progress.

Since there are no tests at this time that can reliably predict which cases will progress, it is recommended that all patients with DCIS be treated. Treatment options include lumpectomy with radiation therapy or mastectomy; either of these options may be followed by treatment with tamoxifen.

Survival: The 5-year relative survival for localized breast cancer (malignant cancer that has not spread to lymph nodes or other locations outside the breast) has increased from 80% in the 1950s to 98% today. If the cancer has spread regionally, the 5-year survival is 83%.

For women with distant spread (metastases), the survival is 26%. Survival after a diagnosis of breast cancer continues to decline after 5 years. The survival rate at 10 years for all stages combined is 80% compared to 89% at 5 years. Caution should be used when interpreting 10-year survival rates since they represent detection and treatment circumstances 5-15 years ago and may underestimate the expected survival based on current conditions.

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