breast%20cancer
BREAST CANCER
Breast cancer is the presence of malignant breast nodule, mass or abscess.
Most common symptom of breast cancer is a new lump or mass in the breast. The lump or mass is usually painless, hard & irregular but it can also be tender, soft, rounded or painful.
Other signs & symptoms include breast pain or nipple pain, nipple discharge, nipple retraction and presence of breast skin changes (eg peau d' orange, nipple excoriation, scaling, inflammation, skin tethering, ulceration, abscess).

Radiotherapy

  • Treatment with high-energy rays or particles that destroy cancer cells
  • Radiation to the breast is strongly recommended after breast-conserving surgery to decrease the chance of recurrence
    • Postmastectomy RT is recommended in T3-T4 tumors and/or >4 positive axillary nodes, considered in 1-3 positive axillary nodes and tumors >5 cm or with pathologic margins
  • Also used to treat cancer that has metastasized to other organs
  • Can be given as external beam radiation or brachytherapy
  • Commonly done after chemotherapy except in patients with negative axillary nodes and tumor with ≤5 cm in size and margins ≥1 mm
  • RT to the chest wall, supraclavicular and infraclavicular areas, and internal mammary nodes is recommended if with positive axillary node involvement
    • RT to the chest wall and internal mammary nodes with or without radiotherapy to the supraclavicular and infraclavicular nodes can be considered in negative axillary nodes and tumor >5 cm or positive margins
    • RT to the chest only in negative axillary nodes and tumor ≤5 cm with close margins of <1 mm

For Stage IIIA (Except T3N1M0), IIIB, IIIC

  • Radiation to the chest wall and supraclavicular nodes is recommended in patients who underwent mastectomy with axillary LN surgery and lumpectomy with axillary LN dissection
  • Internal mammary nodes irradiation is also done if affected
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