Breast cancer refers to both in situ and invasive carcinoma of the breast. Breast cancer can be of either ductal or lobular types. Breast canceris nearly exlusively the disease of women, with only 1% of breast cancers occuring in males. It is the most frequently diagnosed cancer in women and leading cause of death due to cancer in women 20-59 years old. More than 50% occurs in women over age 61.
Risk factors include hormone exposure, family or personal history, lifestyle factors, exposure to radiation; smoking; obesity; early menarche; late menopause; postmenopausal hormone therapy; excessive alcohol use; nulliparity; 5% to 6% are associated with a genetic mutation.
Physical Findings & Clinical Presentation
- Increasind number of small breast cancers are found by mammograms in which case patients are usually completely free of symptoms or physical findings.
- Palpable lump or mass which can be self-detected or physician-detected
- Skin and /or nipple retraction and skin edema, erythema, ulcer, satellite nodule
- Nodal enlargement in axilla and supraclavicular areas
- Nipple discharge may be serous or bloody
- Generalized symptoms and signs, including fatigue, weight loss, jaudice, and anorexia, may be present in metastatic cases.
Both surgery and chemoprevention are utilized to treat women with a family or personal history of breast cancer.
Prognosis- younger women have a poorer prognosis related to hormone shifts and ovulation cycles; well-differentiated breast cancer cells have a better prognosis than undifferentiated cell types; hormone receptor status.
Common sites of metastases are bone (most common), skin, lung, lymph notes, liver, brain; and pleural effusion; many patients present with symptoms associated with metastatic site.
Associated symptoms-lymphedema, pain, nausea, dyspnea, fatigue, anorexia, mental status change.