Usually done for spontaneous unilateral bloody nipple discharge. Sometimes it is done for serous (clear) discharge.
90% of the women with unilateral bloody nipple discharge = benign intraductal papilloma, a solitary discrete intraductal mass. However if multiple masses are discovered in the duct, the more likely the diagnosis will be ductal carcinoma in situ (DCIS).
Regardless of single mass or multiple mass, a surgical biopsy (excisional biopsy) is required for diagnosis. Methylene blue dye can assist the surgeon in removing the duct in the OR.
Pregnancy stops monthly menstrual cycles and shifts the hormone balance to progesterone instead of estrogen; thus women who become pregnant while they are young and have many pregnancies may have slightly lower risk of breast cancer later on because they are exposed to less estrogen.
Core needle biopsy (or fine needle aspiration) is preferred over excisional biopsy which may interfere with subsequent sentinel lymph node biopsy and may compromise the opportunity for induction chemotherapy.
Core needle biopsy can be done at any point during pregnancy.
10% of women under age 40 who develop breast cancer will be pregnant
Gravida is the number of pregnancies.
Para is the number that led to birth.
For example Gravida 3, Para 2 means that the patient has been pregnant 3 times and give birth 2 times. It might mean that the patient is currently pregnant.
When working properly these are tumor supressors. They protect against breast cancer.
But when they are abnormal and genetically inherited – these are called the BRCA1 and BRCA2 genetic mutations.
Normally women have a 12 % lifetime risk of developing breast cancer. Having a BRCA mutation raises the risk to 50-85% with a high likelihood for a recurrence or a second tumor. Risk is the same for BRCA1 or BRCA2
The differences are the risks of associated other cancers.
Future research will discover more differences between BRCA1 and BRCA2.
More info about BRCA mutations and Angelina Jolie
T stands for primary Tumor in the staging of Breast Cancer.
For interest here’s the other T staging designations for Breast Cancer:
Tamoxifen acts like an anti-estrogen in some tissues and acts like estrogen in other tissues.
Tamoxifen is contraindicated in patients who continue to smoke due to the increased risk of thromboembolic disease.
Breast cancer is the second most common cancer in women in the US second only to skin cancer.
Regarding the different types of mammograms (digital vs. film) overall diagnostic accuracy for breast cancer screening was similar but digital mammo was more accurate in women under 50 – more radiographically dense breasts
Costs more
Normal WBC ranges from 3.5-10.5 billion cells/L or cells per mm2
Thus anything above 11 could be considered elevated. But there are levels considered such as mildly elevated or severely elevated.
Hct = 35-50%
Platelets = 150-450 billion/L
Source: http://ww5.komen.org/breastcancer/typesoftumors.html
Ductal Carcinoma is the most common type of breast cancer. There are two types: Ductal Carcinoma In Situ (DCIS)which is considered a pre-malignancy of the breast and there is Invasive Ductal Carcinoma of the breast.
The ducts refer to milk ducts. This type of cancer comes from the lining of a milk duct within the breast. These ducts carry milk from the lobules where the milk is made.
10-30% of all primary breast cancers are diagnosed as locally advanced which prohibits breast conservation methods. Stage III breast cancer is considered locally advanced.
An example would be a 6 cm breast mass diagnosed as infiltrating ductal carcinoma with spread to lymph nodes. (T3 N1 Mx)
Other examples:
Neoadjuvant therapy is a historical term. Now called primary systemic therapy. This is giving chemotherapy prior to operation.
Workup includes bone scan and abdominal CT prior to initiating chemotherapy.
3 peaks
For the older patient with no obvious etiology consider:
A lesser amount of surgery than mastectomy. Lumpectomy