BREAST CANCER

DHARM A W ACANA
M E T R O

By
1. Adi Setiadji sukma
2. nurmala dewi
3. riana puspitasari
4. ridho wonargo
5. yudistiro fajar nugroho
6. sukma indriani
Breast cancer is a cancer that starts in the breast, usually in the inner lining of the milk
ducts or lobules. There are different types of breast cancer, with different stages
(spread), aggressiveness, and genetic makeup. Survival varies greatly depending on
those factors; with best treatment, 10-year disease-free survival varies from 98% to
10%. Treatment includes surgery, drugs (hormone therapy and chemotherapy), and
radiation

Signs and symptoms

The first symptom, or subjective sign, of breast cancer is typically a lump that feels
different from the rest of the breast tissue. According to the The Merck Manual, more
than 80% of breast cancer cases are discovered when the woman feels a lump. [11]
According to the American Cancer Society, the first medical sign, or objective indication
of breast cancer as detected by a physician, is discovered by mammogram.[12] Lumps
found in lymph nodes located in the armpits[11] can also indicate breast cancer.
Indications of breast cancer other than a lump may include changes in breast size or
shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain

("mastodynia") is an unreliable tool in determining the presence or absence of breast

cancer, but may be indicative of other breast health issues.[11][12][13]
When breast cancer cells invade the dermal lymphaticssmall lymph vessels in the skin
of the breastits presentation can resemble skin inflammation and thus is known as
inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain,
swelling, warmth and redness throughout the breast, as well as an orange-peel texture to
the skin referred to as peau d'orange.[11]
Another reported symptom complex of breast cancer is Paget's disease of the breast. This
syndrome presents as eczematoid skin changes such as redness and mild flaking of the
nipple skin. As Paget's advances, symptoms may include tingling, itching, increased
sensitivity, burning, and pain. There may also be discharge from the nipple.
Approximately half of women diagnosed with Paget's also have a lump in the breast.[14]
Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread
beyond the original organ. Metastatic breast cancer will cause symptoms that depend on
the location of metastasis. Common sites of metastasis include bone, liver, lung and
brain.[15] Unexplained weight loss can occasionally herald an occult breast cancer, as can
symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of
metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are
"non-specific", meaning they can also be manifestations of many other illnesses.[16]
Most symptoms of breast disorder do not turn out to represent underlying breast cancer.
Benign breast diseases such as mastitis and fibroadenoma of the breast are more common
causes of breast disorder symptoms. The appearance of a new symptom should be taken
seriously by both patients and their doctors, because of the possibility of an underlying
breast cancer at almost any age.[17]

Management
The mainstay of breast cancer treatment is surgery. Adjuvant hormonal therapy (with
tamoxifen or an aromatase inhibitor) is given when the tumor expresses estrogen
receptors or progesterone receptors. Chemotherapy is given for more advanced stages of
disease. Monoclonal antibodies are sometimes used, especially for HER2-positive
tumors. Radiotherapy is given after surgery to the region of the tumor bed, to destroy
microscopic tumors that may have escaped surgery. Treatments are constantly being
evaluated in randomized, controlled trials, to evaluate and compare individual drugs,
combinations of drugs, and surgical and radiation techniques. The latest research is
reported annually at scientific meetings such as that of the American Society of Clinical
Oncology and St. Gallen, Switzerland.[citation needed] These studies are reviewed by
professional societies and other organizations, and formulated into guidelines for specific
treatment groups and risk category.
In planning treatment, doctors can also use PCR tests like Oncotype DX or microarray
tests that predict breast cancer recurrence risk based on gene expression. In February

2007, the first breast cancer predictor test won formal approval from the Food and Drug
Administration. This is a new gene test to help predict whether women with early-stage
breast cancer will relapse in 5 or 10 years, this could help influence how aggressively the
initial tumor is treated.[38]
Radiation therapy is also used to help destroy cancer cells that may linger after surgery.
Radiation therapy can be delivered as external beam radiotherapy or as brachytherapy
(internal radiotherapy). Radiation can reduce the risk of recurrence by 50-66% (1/2 2/3rds reduction of risk) when delivered in the correct dose.[39]
In 2008, the American College of Surgeons Oncology Group began a National Cancer
Institute funded study to explore the success of cryoablation therapy in the treatment of
Invasive Breast Carcinoma. The Visica 2TM Treatment System from Sanarus Technologies
was chosen as the exclusive cryoablation treatment technology for the study, which is
currently in Phase 2. [40]