This document provides information on breast cancer treatment for health professionals. It discusses the incidence and mortality rates of breast cancer, risk factors, screening, diagnosis, prognostic factors, and considerations after treatment. Key information includes that 231,840 new cases of breast cancer are expected in 2015 in the US, with 40,290 deaths. Risk factors include increasing age, family history, genetic mutations, reproductive factors, and breast density on mammograms. Screening involves mammography, ultrasound, and MRI. Prognosis depends on stage, grade, hormone receptor status, and other pathological features.
There are striking disparities in survival between black and white patients. Dr. Christine Ambrosone and Dr. Song Yao have led a team that has done extensive research to understand the causes of more aggressive cancer in black women. Results from their research may open the door to treatment intervention that could help eliminate these disparities, and the doctors will go over their research and discuss how we can work towards the elimination of racial gaps in breast cancer survival.
HPV is the cause of cervical cancer. There is a long lag between infection and development of cancer. There are two major opportunities to prevent this entirely preventable cancer.
A protocol for the management of breast cancer developed by the multidisciplinary oncology team at University of Nigeria Teaching Hospital, fully adapted to our environment
There are striking disparities in survival between black and white patients. Dr. Christine Ambrosone and Dr. Song Yao have led a team that has done extensive research to understand the causes of more aggressive cancer in black women. Results from their research may open the door to treatment intervention that could help eliminate these disparities, and the doctors will go over their research and discuss how we can work towards the elimination of racial gaps in breast cancer survival.
HPV is the cause of cervical cancer. There is a long lag between infection and development of cancer. There are two major opportunities to prevent this entirely preventable cancer.
A protocol for the management of breast cancer developed by the multidisciplinary oncology team at University of Nigeria Teaching Hospital, fully adapted to our environment
Topic-Driven Round Table on Ovarian Cancer: Understanding Genetics and Ovaria...bkling
Women with ovarian cancer joined Julie Larson, LCSW, guest speaker Dr. Kathryn Pennington of UW Medicine, and peers via video or phone to discuss genetics and ovarian cancer.
Cancer genetic testing and risk assessment overview.
This slide deck was the basis of a presentation to nurse practitioners and genetic counselors who are actively identifying and managing women at high risk of breast and ovarian cancer.
Uterine Cancer Recurrence: All You Need To Knowbkling
t's not uncommon for uterine cancer survivors to worry about recurrence.
Whether you've had a recurrence or want to become more informed, join Dr. Susan C. Modesitt, Director of Gynecologic Oncology at UVA Cancer Center, to learn more information about uterine cancer recurrence as well as available treatment options.
HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
Gain a deeper understanding of uterine and endometrial cancer symptoms, diagnosis, treatment options, and current research trends with Dr. Jason D. Wright, Division Chief of Gynecologic Oncology at New York-Presbyterian/Columbia University Medical Center. This webinar is a collaboration with the Foundation for Women's Cancer.
Report Back from SGO: What’s the Latest in Uterine Cancer?bkling
Dr. Jeannine Villella, Chief of Gynecologic Oncology at Lenox Hill Hospital, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Villella breaks down what the research presented at the conference means for you and discusses new developments.
All in the Family: Hereditary Risk for Gynecologic Cancerbkling
Knowing and understanding your inherited genetics is important for ovarian and uterine cancer patients. Dr. Melissa Frey, gynecologic oncologist at Weill Cornell Medicine, discusses how genetic factors affect women with ovarian and uterine cancer and influence treatment decisions, with a particular focus on BRCA1 & 2 and Lynch Syndrome.
This webinar was being put on in partnership with FORCE.
Deborah Collyar, President, Patient Advocates In Research, discusses what new research is telling us about DCIS, both here and abroad. What is low risk DCIS? Is it okay to monitor your DCIS? Is Endocrine Therapy absolutely necessary? What does the future look like? Deborah addresses this and so much more.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
Toward Integrated Clinical and Gene Expression Profiles for Breast Cancer Pro...CSCJournals
Breast cancer patients with the same diagnostic and clinical prognostic profile can have markedly different clinical outcome. This difference is possibly caused by the limitation of current breast cancer prognostic indices, which group molecularly distinct patients into similar clinical classes based mainly on morphological of disease. Traditional clinical based prognosis models were discovered contain some restriction to address the heterogeneity of breast cancer. The invention of microarray technology and its ability to simultaneously interrogate thousands genes has changed the paradigm of molecular classification of human cancers as well as it shifted clinical prognosis model to broader prospect. Numerous studies have revealed the potential value of gene expression signatures in examining the risk of disease recurrence. However, currently most of these studies attempted to implement genetic marker based prognostic models to replace the traditional clinical markers, yet neglecting the rich information contain in clinical information. Therefore, this research took an effort to integrate both clinical and microarray data in order to obtain accurate breast cancer prognosis, by taking into account that these data complements each other. This article presents a review of the development of breast cancer prognosis models, concentrating precisely on clinical and gene expression profiles. The literature is reviewed in an explicit machine learning framework, which include the elements of feature selection and classification techniques.
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
Topic-Driven Round Table on Ovarian Cancer: Understanding Genetics and Ovaria...bkling
Women with ovarian cancer joined Julie Larson, LCSW, guest speaker Dr. Kathryn Pennington of UW Medicine, and peers via video or phone to discuss genetics and ovarian cancer.
Cancer genetic testing and risk assessment overview.
This slide deck was the basis of a presentation to nurse practitioners and genetic counselors who are actively identifying and managing women at high risk of breast and ovarian cancer.
Uterine Cancer Recurrence: All You Need To Knowbkling
t's not uncommon for uterine cancer survivors to worry about recurrence.
Whether you've had a recurrence or want to become more informed, join Dr. Susan C. Modesitt, Director of Gynecologic Oncology at UVA Cancer Center, to learn more information about uterine cancer recurrence as well as available treatment options.
HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mu...Dr.Samsuddin Khan
Background: HIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.
Methods: From May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).
Results: Ninety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/µL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.
Conclusion: The high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.
Gain a deeper understanding of uterine and endometrial cancer symptoms, diagnosis, treatment options, and current research trends with Dr. Jason D. Wright, Division Chief of Gynecologic Oncology at New York-Presbyterian/Columbia University Medical Center. This webinar is a collaboration with the Foundation for Women's Cancer.
Report Back from SGO: What’s the Latest in Uterine Cancer?bkling
Dr. Jeannine Villella, Chief of Gynecologic Oncology at Lenox Hill Hospital, provides a comprehensive update from the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. Dr. Villella breaks down what the research presented at the conference means for you and discusses new developments.
All in the Family: Hereditary Risk for Gynecologic Cancerbkling
Knowing and understanding your inherited genetics is important for ovarian and uterine cancer patients. Dr. Melissa Frey, gynecologic oncologist at Weill Cornell Medicine, discusses how genetic factors affect women with ovarian and uterine cancer and influence treatment decisions, with a particular focus on BRCA1 & 2 and Lynch Syndrome.
This webinar was being put on in partnership with FORCE.
Deborah Collyar, President, Patient Advocates In Research, discusses what new research is telling us about DCIS, both here and abroad. What is low risk DCIS? Is it okay to monitor your DCIS? Is Endocrine Therapy absolutely necessary? What does the future look like? Deborah addresses this and so much more.
Dr. Jennifer Mueller, gynecologic cancer surgeon at Memorial Sloan Kettering Cancer Center, will share research updates on uterine/endometrial cancer and other new developments in treatment and surgery.
Toward Integrated Clinical and Gene Expression Profiles for Breast Cancer Pro...CSCJournals
Breast cancer patients with the same diagnostic and clinical prognostic profile can have markedly different clinical outcome. This difference is possibly caused by the limitation of current breast cancer prognostic indices, which group molecularly distinct patients into similar clinical classes based mainly on morphological of disease. Traditional clinical based prognosis models were discovered contain some restriction to address the heterogeneity of breast cancer. The invention of microarray technology and its ability to simultaneously interrogate thousands genes has changed the paradigm of molecular classification of human cancers as well as it shifted clinical prognosis model to broader prospect. Numerous studies have revealed the potential value of gene expression signatures in examining the risk of disease recurrence. However, currently most of these studies attempted to implement genetic marker based prognostic models to replace the traditional clinical markers, yet neglecting the rich information contain in clinical information. Therefore, this research took an effort to integrate both clinical and microarray data in order to obtain accurate breast cancer prognosis, by taking into account that these data complements each other. This article presents a review of the development of breast cancer prognosis models, concentrating precisely on clinical and gene expression profiles. The literature is reviewed in an explicit machine learning framework, which include the elements of feature selection and classification techniques.
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
Breast Cancer in Young Women and its Impact on Reproductive FunctionApollo Hospitals
Breast cancer is the most common cancer in women in developed countries. Chemotherapy for breast cancer is likely to negatively impact on reproductive function. We review current treatment; effects on reproductive function; breastfeeding and management of menopausal symptoms following breast cancer.
A prospective study of breast lump andclinicopathologicalanalysis in relation...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Original StudyType of Breast Cancer Diagnosis, Screening,a.docxvannagoforth
Original Study
Type of Breast Cancer Diagnosis, Screening,
and Survival
Carla Cedolini,1 Serena Bertozzi,1 Ambrogio P. Londero,2 Sergio Bernardi,3,4
Luca Seriau,1 Serena Concina,1 Federico Cattin,1 Andrea Risaliti1
Abstract
Organized, invitational breast cancer screening in our population succeeded in detecting early-stage tumors,
which have been consequently treated more frequently with breast and axillary conservative surgery, com-
plementary breast irradiation, and eventual hormonal therapy. The diagnosis of invasive cancer with screening
in our population resulted in a survival gain at 5 years from the diagnosis.
Introduction: Breast cancer screening is known to reduce mortality. In the present study, we analyzed the prevalence
of breast cancers detected through screening, before and after introduction of an organized screening, and we
evaluated the overall survival of these patients in comparison with women with an extrascreening imaging-detected
breast cancer or those with palpable breast cancers. Materials and Methods: We collected data about all women
who underwent a breast operation for cancer in our department between 2001 and 2008, focusing on type of tumor
diagnosis, tumor characteristics, therapies administered, and patient outcome in terms of overall survival, and re-
currences. Data was analyzed by R (version 2.15.2), and P < .05 was considered significant. Results: Among the 2070
cases of invasive breast cancer we considered, 157 were detected by regional mammographic screening (group A),
843 by extrascreening breast imaging (group B: 507 by mammography and 336 by ultrasound), and 1070 by extra-
screening breast objective examination (group C). The 5-year overall survival in groups A, B, and C were, respectively,
99% (95% CI, 98%-100%), 98% (95% CI, 97%-99%), and 91% (95% CI, 90%-93%), with a significant difference
between the first 2 groups and the third (P < .05) and a trend between groups A and B (P ¼ .081). Conclusion: The
diagnosis of invasive breast cancer with screening in our population resulted in a survival gain at 5 years from the
diagnosis, but a longer follow-up is necessary to confirm this data.
Clinical Breast Cancer, Vol. 14, No. 4, 235-40 ª 2014 Elsevier Inc. All rights reserved.
Keywords: Breast cancer, Breast cancer screening, Invasive breast cancer, Mammographic screening, Overall survival
Introduction
Because of the detection of early-stage tumors, breast cancer
screening reduced breast cancer mortality in Europe by 25%-31%
in patients who were invited for screening and by 38%-48% in
those who were actually screened during the last decade of the
twentieth century and the first decade of the twenty-first.1 In our
region of Italy, an organized breast cancer screening was firstly intro-
duced in 2005, but despite the high compliance of invited women
1Clinic of Surgery
2Clinic of Obstetrics and Gynecology
University of Udine, Udine, Italy
3Department of Surgery, Ospedale Civile di Latisana, Udine, Italy
4 ...
Studies have shown that older women receive less aggressive screening and treatment for breast cancer. Geriatric Oncologist, Meghan Karuturi, of MD Anderson Cancer Center joins us in this webinar to discuss age bias and how it affects older patients.
BRCA – Importance in Hereditary Breast & Ovarian CancerLifecare Centre
BRCA – Importance in Hereditary
Breast & Ovarian Cancer
DGF & WOW India
presentation was made by
Dr Sharda Jain
based on presentation made by
Dr Sunil Tadepalli
1. Skip to content
Español
1-800-4-CANCER Live Chat Publications Dictionary
About Cancer
o
o
o
o
o
o
o
o
Cancer Types
o
3.
o
Grants & Training
o
o
o
o
o
News & Events
o
o
o
o
About NCI
o
4.
o
o
o
o
o
o
Search
Home
Cancer Types
Breast Cancer
Health Professional
Breast Cancer
o Patient
o
o Health Professional
Breast Cancer Treatment
Male Breast Cancer Treatment
Breast Cancer Treatment & Pregnancy
Breast Cancer Prevention
Genetics of Breast & Gynecologic Cancers
Breast Cancer Screening
o Research
Breast Cancer Treatment–for health
professionals (PDQ®)
Sections
5. General Information About Breast Cancer
Histopathologic Classification of Breast Cancer
Stage Information for Breast Cancer
Ductal Carcinoma In Situ
Early/Localized/Operable Breast Cancer
Stage IIIB, Inoperable IIIC, IV, Recurrent, and Metastatic Breast Cancer
Changes to This Summary (10/30/2015)
About This PDQ Summary
Get More Information From NCI
View All Sections
General Information About Breast Cancer
Incidence and Mortality
Anatomy
Risk and Protective Factors
Screening
Diagnosis
o Patient evaluation
o Contralateral disease
Prognostic Factors
Posttherapy Considerations
o Hormone replacement therapy
Related Summaries
This summary discusses primary epithelial breast cancers in women. The breast is rarely
affected by other tumors such as lymphomas, sarcomas, or melanomas. Refer to the following
PDQ summaries for more information on these cancer types:
Adult Hodgkin Lymphoma Treatment
Adult Soft Tissue Sarcoma Treatment
Melanoma Treatment
Breast cancer also affects men and children and may occur during pregnancy, although it is
rare in these populations. Refer to the following PDQ summaries for more information:
Male Breast Cancer Treatment
Breast Cancer Treatment and Pregnancy
Unusual Cancers of Childhood Treatment
Incidence and Mortality
Estimated new cases and deaths from breast cancer (women only) in the United States in
2015:[1]
New cases: 231,840.
Deaths: 40,290.
6. Breast cancer is the most common noncutaneous cancer in U.S. women, with an estimated
60,290 cases of in situ disease, 231,840 new cases of invasive disease, and 40,290 deaths
expected in 2015.[1] Thus, fewer than one of six women diagnosed with breast cancer die of
the disease. By comparison, it is estimated that about 71,660 American women will die of
lung cancer in 2015.[1] Men account for 1% of breast cancer cases and breast cancer deaths
(refer to the Special Populations section in the PDQ summary on Breast Cancer Screening for
more information).
Widespread adoption of screening increases breast cancer incidence in a given population and
changes the characteristics of cancers detected, with increased incidence of lower-risk
cancers, premalignant lesions, and ductal carcinoma in situ (DCIS). (Refer to the Ductal
Carcinoma In Situ section in the Breast Cancer Diagnosis and Pathology section in the PDQ
summary on Breast Cancer Screening for more information.) Population studies from the
United States [2] and the United Kingdom [3] demonstrate an increase in DCIS and invasive
breast cancer incidence since the 1970s, attributable to the widespread adoption of both
postmenopausal hormone therapy and screening mammography. In the last decade, women
have refrained from using postmenopausal hormones, and breast cancer incidence has
declined, but not to the levels seen before the widespread use of screening mammography.[4]
Anatomy
7. Enlarge
Anatomy of the female breast. The nipple and areola are shown on the outside of the breast.
The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also
shown.
Risk and Protective Factors
Increasing age is the most important risk factor for breast cancer.[2] Other risk factors for
breast cancer include the following:
Family health history.[5]
Major inheritance susceptibility.[6-8]
o Germline mutation of the genes BRCA1 and BRCA2, and other breast cancer
susceptibility genes.[9-13]
Alcohol intake.[14]
Breast tissue density (mammographic).[15,16]
Estrogen (endogenous):[17-20]
o Menstrual history (early menarche/late menopause).[21-23]
o Nulliparity.
o Older age at first birth.
8. Hormone therapy history:[24]
o Combination estrogen plus progestin hormone replacement therapy
(HRT).[25-28]
Obesity.[29,30]
Personal history of breast cancer.[31]
Personal history of proliferative forms of benign breast disease.[32-38]
Race.[39,40]
Radiation exposure to the breast/chest.[41,42]
Age-specific risk estimates are available to help counsel and design screening strategies for
women with a family history of breast cancer.[43,44]
Of all women with breast cancer, 5% to 10% may have a germline mutation of the genes
BRCA1 and BRCA2.[45] Specific mutations of BRCA1 and BRCA2 are more common in
women of Jewish ancestry.[46] The estimated lifetime risk of developing breast cancer for
women with BRCA1 and BRCA2 mutations is 40% to 85%. Carriers with a history of breast
cancer have an increased risk of contralateral disease that may be as high as 5% per year.[47]
Male BRCA2 mutation carriers also have an increased risk of breast cancer.[48]
Mutations in either the BRCA1 or the BRCA2 gene also confer an increased risk of ovarian
cancer [48,49] or other primary cancers.[48,49] Once a BRCA1 or BRCA2 mutation has been
identified, other family members can be referred for genetic counseling and testing.[50-53]
(Refer to the PDQ summaries on Genetics of Breast and Gynecologic Cancers; Breast Cancer
Prevention; and Breast Cancer Screening for more information.)
(Refer to the PDQ summary on Breast Cancer Prevention for more information about factors
that increase the risk of breast cancer.)
Protective factors and interventions to reduce the risk of female breast cancer include the
following:
Estrogen use (after hysterectomy).[54-56]
Exercise.[57-59]
Early pregnancy.[23,60,61]
Breast feeding.[62]
Selective estrogen receptor modulators (SERMs).[63]
Aromatase inhibitors or inactivators.[64,65]
Risk-reducing mastectomy.[66]
Risk-reducing oophorectomy or ovarian ablation.[67-70]
(Refer to the PDQ summary on Breast Cancer Prevention for more information about factors
that decrease the risk of breast cancer.)
Screening
Clinical trials have established that screening asymptomatic women using mammography,
with or without clinical breast examination, decreases breast cancer mortality. (Refer to the
PDQ summary on Breast Cancer Screening for more information.)
Diagnosis
9. Patient evaluation
When breast cancer is suspected, patient management generally includes the following:
Confirmation of the diagnosis.
Evaluation of the stage of disease.
Selection of therapy.
The following tests and procedures are used to diagnose breast cancer:
Mammography.
Ultrasound.
Breast magnetic resonance imaging (MRI), if clinically indicated.
Biopsy.
Contralateral disease
Pathologically, breast cancer can be a multicentric and bilateral disease. Bilateral disease is
somewhat more common in patients with infiltrating lobular carcinoma. At 10 years after
diagnosis, the risk of a primary breast cancer in the contralateral breast ranges from 3% to
10%, although endocrine therapy decreases that risk.[71-73] The development of a
contralateral breast cancer is associated with an increased risk of distant recurrence.[74]
When BRCA1/BRCA2 mutation carriers were diagnosed before age 40 years, the risk of a
contralateral breast cancer reached nearly 50% in the ensuing 25 years.[75,76]
Patients who have breast cancer will undergo bilateral mammography at the time of diagnosis
to rule out synchronous disease. To detect either recurrence in the ipsilateral breast in patients
treated with breast-conserving surgery or a second primary cancer in the contralateral breast,
patients will continue to have regular breast physical examinations and mammograms.
The role of MRI in screening the contralateral breast and monitoring women treated with
breast-conserving therapy continues to evolve. Because an increased detection rate of
mammographically occult disease has been demonstrated, the selective use of MRI for
additional screening is occurring more frequently despite the absence of randomized,
controlled data. Because only 25% of MRI-positive findings represent malignancy,
pathologic confirmation before treatment is recommended. Whether this increased detection
rate will translate into improved treatment outcome is unknown.[77-79]
Prognostic Factors
Breast cancer is commonly treated by various combinations of surgery, radiation therapy,
chemotherapy, and hormone therapy. Prognosis and selection of therapy may be influenced
by the following clinical and pathology features (based on conventional histology and
immunohistochemistry):[80]
The menopausal status of the patient.
The stage of the disease.
The grade of the primary tumor.
The estrogen receptor (ER) and progesterone receptor (PR) status of the tumor.
10. Human epidermal growth factor type 2 receptor (HER2/neu) overexpression and/or
amplification.
The histologic type. Breast cancer is classified into a variety of histologic types, some
of which have prognostic importance. For example, favorable histologic types include
mucinous, medullary, and tubular carcinomas.[81-83]
The use of molecular profiling in breast cancer includes the following:[84]
ER and PR status testing.
HER2/neu receptor status testing.
Gene profile testing by microarray assay or reverse transcription-polymerase chain
reaction (e.g., MammaPrint, Oncotype DX).
On the basis of these results, breast cancer is classified as:
Hormone-receptor positive.
HER2 positive.
Triple negative (ER, PR, and Her2/neu negative).
Although certain rare inherited mutations, such as those of BRCA1 and BRCA2, predispose
women to develop breast cancer, prognostic data on BRCA1/BRCA2 mutation carriers who
have developed breast cancer are conflicting; these women are at greater risk of developing
contralateral breast cancer.
Posttherapy Considerations
Hormone replacement therapy
After careful consideration, patients with severe symptoms may be treated with hormone
replacement therapy. For more information, refer to the following PDQ summaries:
Breast Cancer Prevention
Hot Flashes and Night Sweats
Related Summaries
Other PDQ summaries containing information related to breast cancer include the following:
Breast Cancer Prevention
Breast Cancer Screening
Breast Cancer Treatment and Pregnancy
Genetics of Breast and Gynecologic Cancers
Male Breast Cancer Treatment
Unusual Cancers of Childhood Treatment (breast cancer in children)
References
1. American Cancer Society: Cancer Facts and Figures 2015. Atlanta, Ga: American
Cancer Society, 2015. Available onlineExit Disclaimer. Last accessed October 30,
2015.
11. 2. Altekruse SF, Kosary CL, Krapcho M, et al.: SEER Cancer Statistics Review, 1975-
2007. Bethesda, Md: National Cancer Institute, 2010. Also available online. Last
accessed October 9, 2015.
3. Johnson A, Shekhdar J: Breast cancer incidence: what do the figures mean? J Eval
Clin Pract 11 (1): 27-31, 2005. [PUBMED Abstract]
4. Haas JS, Kaplan CP, Gerstenberger EP, et al.: Changes in the use of postmenopausal
hormone therapy after the publication of clinical trial results. Ann Intern Med 140 (3):
184-8, 2004. [PUBMED Abstract]
5. Colditz GA, Rosner BA, Speizer FE: Risk factors for breast cancer according to
family history of breast cancer. For the Nurses' Health Study Research Group. J Natl
Cancer Inst 88 (6): 365-71, 1996. [PUBMED Abstract]
6. Colditz GA, Kaphingst KA, Hankinson SE, et al.: Family history and risk of breast
cancer: nurses' health study. Breast Cancer Res Treat 133 (3): 1097-104,
2012. [PUBMED Abstract]
7. Malone KE, Daling JR, Doody DR, et al.: Family history of breast cancer in relation
to tumor characteristics and mortality in a population-based study of young women
with invasive breast cancer. Cancer Epidemiol Biomarkers Prev 20 (12): 2560-71,
2011. [PUBMED Abstract]
8. Cybulski C, Wokołorczyk D, Jakubowska A, et al.: Risk of breast cancer in women
with a CHEK2 mutation with and without a family history of breast cancer. J Clin
Oncol 29 (28): 3747-52, 2011. [PUBMED Abstract]
9. Goodwin PJ, Phillips KA, West DW, et al.: Breast cancer prognosis in BRCA1 and
BRCA2 mutation carriers: an International Prospective Breast Cancer Family
Registry population-based cohort study. J Clin Oncol 30 (1): 19-26, 2012. [PUBMED
Abstract]
10. Mavaddat N, Barrowdale D, Andrulis IL, et al.: Pathology of breast and ovarian
cancers among BRCA1 and BRCA2 mutation carriers: results from the Consortium of
Investigators of Modifiers of BRCA1/2 (CIMBA). Cancer Epidemiol Biomarkers
Prev 21 (1): 134-47, 2012. [PUBMED Abstract]
11. Miki Y, Swensen J, Shattuck-Eidens D, et al.: A strong candidate for the breast and
ovarian cancer susceptibility gene BRCA1. Science 266 (5182): 66-71,
1994. [PUBMED Abstract]
12. Futreal PA, Liu Q, Shattuck-Eidens D, et al.: BRCA1 mutations in primary breast and
ovarian carcinomas. Science 266 (5182): 120-2, 1994. [PUBMED Abstract]
13. Wooster R, Neuhausen SL, Mangion J, et al.: Localization of a breast cancer
susceptibility gene, BRCA2, to chromosome 13q12-13. Science 265 (5181): 2088-90,
1994. [PUBMED Abstract]
14. Hamajima N, Hirose K, Tajima K, et al.: Alcohol, tobacco and breast cancer--
collaborative reanalysis of individual data from 53 epidemiological studies, including
58,515 women with breast cancer and 95,067 women without the disease. Br J Cancer
87 (11): 1234-45, 2002. [PUBMED Abstract]
15. Boyd NF, Martin LJ, Rommens JM, et al.: Mammographic density: a heritable risk
factor for breast cancer. Methods Mol Biol 472: 343-60, 2009. [PUBMED Abstract]
16. McCormack VA, dos Santos Silva I: Breast density and parenchymal patterns as
markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev 15
(6): 1159-69, 2006. [PUBMED Abstract]
17. Key TJ, Appleby PN, Reeves GK, et al.: Circulating sex hormones and breast cancer
risk factors in postmenopausal women: reanalysis of 13 studies. Br J Cancer 105 (5):
709-22, 2011. [PUBMED Abstract]
12. 18. Kaaks R, Rinaldi S, Key TJ, et al.: Postmenopausal serum androgens, oestrogens and
breast cancer risk: the European prospective investigation into cancer and nutrition.
Endocr Relat Cancer 12 (4): 1071-82, 2005. [PUBMED Abstract]
19. Kaaks R, Berrino F, Key T, et al.: Serum sex steroids in premenopausal women and
breast cancer risk within the European Prospective Investigation into Cancer and
Nutrition (EPIC). J Natl Cancer Inst 97 (10): 755-65, 2005. [PUBMED Abstract]
20. Endogenous Hormones and Breast Cancer Collaborative Group: Endogenous sex
hormones and breast cancer in postmenopausal women: reanalysis of nine prospective
studies. J Natl Cancer Inst 94 (8): 606-16, 2002. [PUBMED Abstract]
21. Collaborative Group on Hormonal Factors in Breast Cancer: Menarche, menopause,
and breast cancer risk: individual participant meta-analysis, including 118 964 women
with breast cancer from 117 epidemiological studies. Lancet Oncol 13 (11): 1141-51,
2012. [PUBMED Abstract]
22. Ritte R, Lukanova A, Tjønneland A, et al.: Height, age at menarche and risk of
hormone receptor-positive and -negative breast cancer: a cohort study. Int J Cancer
132 (11): 2619-29, 2013. [PUBMED Abstract]
23. Kampert JB, Whittemore AS, Paffenbarger RS Jr: Combined effect of childbearing,
menstrual events, and body size on age-specific breast cancer risk. Am J Epidemiol
128 (5): 962-79, 1988. [PUBMED Abstract]
24. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from
51 epidemiological studies of 52,705 women with breast cancer and 108,411 women
without breast cancer. Collaborative Group on Hormonal Factors in Breast Cancer.
Lancet 350 (9084): 1047-59, 1997. [PUBMED Abstract]
25. Writing Group for the Women's Health Initiative Investigators: Risks and benefits of
estrogen plus progestin in healthy postmenopausal women: principal results From the
Women's Health Initiative randomized controlled trial. JAMA 288 (3): 321-33,
2002. [PUBMED Abstract]
26. Chlebowski RT, Anderson GL, Gass M, et al.: Estrogen plus progestin and breast
cancer incidence and mortality in postmenopausal women. JAMA 304 (15): 1684-92,
2010. [PUBMED Abstract]
27. Chlebowski RT, Hendrix SL, Langer RD, et al.: Influence of estrogen plus progestin
on breast cancer and mammography in healthy postmenopausal women: the Women's
Health Initiative Randomized Trial. JAMA 289 (24): 3243-53, 2003. [PUBMED
Abstract]
28. Chlebowski RT, Manson JE, Anderson GL, et al.: Estrogen plus progestin and breast
cancer incidence and mortality in the Women's Health Initiative Observational Study.
J Natl Cancer Inst 105 (8): 526-35, 2013. [PUBMED Abstract]
29. Wolin KY, Carson K, Colditz GA: Obesity and cancer. Oncologist 15 (6): 556-65,
2010. [PUBMED Abstract]
30. Morimoto LM, White E, Chen Z, et al.: Obesity, body size, and risk of
postmenopausal breast cancer: the Women's Health Initiative (United States). Cancer
Causes Control 13 (8): 741-51, 2002. [PUBMED Abstract]
31. Kotsopoulos J, Chen WY, Gates MA, et al.: Risk factors for ductal and lobular breast
cancer: results from the nurses' health study. Breast Cancer Res 12 (6): R106,
2010. [PUBMED Abstract]
32. Goldacre MJ, Abisgold JD, Yeates DG, et al.: Benign breast disease and subsequent
breast cancer: English record linkage studies. J Public Health (Oxf) 32 (4): 565-71,
2010. [PUBMED Abstract]
13. 33. Kabat GC, Jones JG, Olson N, et al.: A multi-center prospective cohort study of
benign breast disease and risk of subsequent breast cancer. Cancer Causes Control 21
(6): 821-8, 2010. [PUBMED Abstract]
34. Worsham MJ, Raju U, Lu M, et al.: Risk factors for breast cancer from benign breast
disease in a diverse population. Breast Cancer Res Treat 118 (1): 1-7,
2009. [PUBMED Abstract]
35. Pearlman MD, Griffin JL: Benign breast disease. Obstet Gynecol 116 (3): 747-58,
2010. [PUBMED Abstract]
36. Vogel VG: Epidemiology, genetics, and risk evaluation of postmenopausal women at
risk of breast cancer. Menopause 15 (4 Suppl): 782-9, 2008 Jul-Aug. [PUBMED
Abstract]
37. Degnim AC, Visscher DW, Berman HK, et al.: Stratification of breast cancer risk in
women with atypia: a Mayo cohort study. J Clin Oncol 25 (19): 2671-7,
2007. [PUBMED Abstract]
38. Worsham MJ, Abrams J, Raju U, et al.: Breast cancer incidence in a cohort of women
with benign breast disease from a multiethnic, primary health care population. Breast
J 13 (2): 115-21, 2007 Mar-Apr. [PUBMED Abstract]
39. Razzaghi H, Troester MA, Gierach GL, et al.: Mammographic density and breast
cancer risk in White and African American Women. Breast Cancer Res Treat 135 (2):
571-80, 2012. [PUBMED Abstract]
40. Pfeiffer RM, Mitani A, Matsuno RK, et al.: Racial differences in breast cancer trends
in the United States (2000-2004). J Natl Cancer Inst 100 (10): 751-2,
2008. [PUBMED Abstract]
41. Andrieu N, Easton DF, Chang-Claude J, et al.: Effect of chest X-rays on the risk of
breast cancer among BRCA1/2 mutation carriers in the international BRCA1/2 carrier
cohort study: a report from the EMBRACE, GENEPSO, GEO-HEBON, and IBCCS
Collaborators' Group. J Clin Oncol 24 (21): 3361-6, 2006. [PUBMED Abstract]
42. Bhatia S, Robison LL, Oberlin O, et al.: Breast cancer and other second neoplasms
after childhood Hodgkin's disease. N Engl J Med 334 (12): 745-51, 1996. [PUBMED
Abstract]
43. Claus EB, Risch N, Thompson WD: Autosomal dominant inheritance of early-onset
breast cancer. Implications for risk prediction. Cancer 73 (3): 643-51,
1994. [PUBMED Abstract]
44. Gail MH, Brinton LA, Byar DP, et al.: Projecting individualized probabilities of
developing breast cancer for white females who are being examined annually. J Natl
Cancer Inst 81 (24): 1879-86, 1989. [PUBMED Abstract]
45. Blackwood MA, Weber BL: BRCA1 and BRCA2: from molecular genetics to clinical
medicine. J Clin Oncol 16 (5): 1969-77, 1998. [PUBMED Abstract]
46. Offit K, Gilewski T, McGuire P, et al.: Germline BRCA1 185delAG mutations in
Jewish women with breast cancer. Lancet 347 (9016): 1643-5, 1996. [PUBMED
Abstract]
47. Frank TS, Manley SA, Olopade OI, et al.: Sequence analysis of BRCA1 and BRCA2:
correlation of mutations with family history and ovarian cancer risk. J Clin Oncol 16
(7): 2417-25, 1998. [PUBMED Abstract]
48. Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J
Natl Cancer Inst 91 (15): 1310-6, 1999. [PUBMED Abstract]
49. Ford D, Easton DF, Bishop DT, et al.: Risks of cancer in BRCA1-mutation carriers.
Breast Cancer Linkage Consortium. Lancet 343 (8899): 692-5, 1994. [PUBMED
Abstract]
14. 50. Biesecker BB, Boehnke M, Calzone K, et al.: Genetic counseling for families with
inherited susceptibility to breast and ovarian cancer. JAMA 269 (15): 1970-4,
1993. [PUBMED Abstract]
51. Berry DA, Parmigiani G, Sanchez J, et al.: Probability of carrying a mutation of
breast-ovarian cancer gene BRCA1 based on family history. J Natl Cancer Inst 89 (3):
227-38, 1997. [PUBMED Abstract]
52. Hoskins KF, Stopfer JE, Calzone KA, et al.: Assessment and counseling for women
with a family history of breast cancer. A guide for clinicians. JAMA 273 (7): 577-85,
1995. [PUBMED Abstract]
53. Statement of the American Society of Clinical Oncology: genetic testing for cancer
susceptibility, Adopted on February 20, 1996. J Clin Oncol 14 (5): 1730-6; discussion
1737-40, 1996. [PUBMED Abstract]
54. Anderson GL, Limacher M, Assaf AR, et al.: Effects of conjugated equine estrogen in
postmenopausal women with hysterectomy: the Women's Health Initiative
randomized controlled trial. JAMA 291 (14): 1701-12, 2004. [PUBMED Abstract]
55. LaCroix AZ, Chlebowski RT, Manson JE, et al.: Health outcomes after stopping
conjugated equine estrogens among postmenopausal women with prior hysterectomy:
a randomized controlled trial. JAMA 305 (13): 1305-14, 2011. [PUBMED Abstract]
56. Anderson GL, Chlebowski RT, Aragaki AK, et al.: Conjugated equine oestrogen and
breast cancer incidence and mortality in postmenopausal women with hysterectomy:
extended follow-up of the Women's Health Initiative randomised placebo-controlled
trial. Lancet Oncol 13 (5): 476-86, 2012. [PUBMED Abstract]
57. Bernstein L, Henderson BE, Hanisch R, et al.: Physical exercise and reduced risk of
breast cancer in young women. J Natl Cancer Inst 86 (18): 1403-8, 1994. [PUBMED
Abstract]
58. Thune I, Brenn T, Lund E, et al.: Physical activity and the risk of breast cancer. N
Engl J Med 336 (18): 1269-75, 1997. [PUBMED Abstract]
59. Adams-Campbell LL, Rosenberg L, Rao RS, et al.: Strenuous physical activity and
breast cancer risk in African-American women. J Natl Med Assoc 93 (7-8): 267-75,
2001 Jul-Aug. [PUBMED Abstract]
60. Pike MC, Krailo MD, Henderson BE, et al.: 'Hormonal' risk factors, 'breast tissue age'
and the age-incidence of breast cancer. Nature 303 (5920): 767-70, 1983. [PUBMED
Abstract]
61. Lambe M, Hsieh C, Trichopoulos D, et al.: Transient increase in the risk of breast
cancer after giving birth. N Engl J Med 331 (1): 5-9, 1994. [PUBMED Abstract]
62. Col: Breast cancer and breastfeeding: collaborative reanalysis of individual data from
47 epidemiological studies in 30 countries, including 50302 women with breast
cancer and 96973 women without the disease. Lancet 360 (9328): 187-95,
2002. [PUBMED Abstract]
63. Cuzick J, Sestak I, Bonanni B, et al.: Selective oestrogen receptor modulators in
prevention of breast cancer: an updated meta-analysis of individual participant data.
Lancet 381 (9880): 1827-34, 2013. [PUBMED Abstract]
64. Goss PE, Ingle JN, Alés-Martínez JE, et al.: Exemestane for breast-cancer prevention
in postmenopausal women. N Engl J Med 364 (25): 2381-91, 2011. [PUBMED
Abstract]
65. Cuzick J, Sestak I, Forbes JF, et al.: Anastrozole for prevention of breast cancer in
high-risk postmenopausal women (IBIS-II): an international, double-blind,
randomised placebo-controlled trial. Lancet 383 (9922): 1041-8, 2014. [PUBMED
Abstract]
15. 66. Hartmann LC, Schaid DJ, Woods JE, et al.: Efficacy of bilateral prophylactic
mastectomy in women with a family history of breast cancer. N Engl J Med 340 (2):
77-84, 1999. [PUBMED Abstract]
67. Rebbeck TR, Levin AM, Eisen A, et al.: Breast cancer risk after bilateral prophylactic
oophorectomy in BRCA1 mutation carriers. J Natl Cancer Inst 91 (17): 1475-9,
1999. [PUBMED Abstract]
68. Kauff ND, Satagopan JM, Robson ME, et al.: Risk-reducing salpingo-oophorectomy
in women with a BRCA1 or BRCA2 mutation. N Engl J Med 346 (21): 1609-15,
2002. [PUBMED Abstract]
69. Rebbeck TR, Lynch HT, Neuhausen SL, et al.: Prophylactic oophorectomy in carriers
of BRCA1 or BRCA2 mutations. N Engl J Med 346 (21): 1616-22, 2002. [PUBMED
Abstract]
70. Kauff ND, Domchek SM, Friebel TM, et al.: Risk-reducing salpingo-oophorectomy
for the prevention of BRCA1- and BRCA2-associated breast and gynecologic cancer:
a multicenter, prospective study. J Clin Oncol 26 (8): 1331-7, 2008. [PUBMED
Abstract]
71. Rosen PP, Groshen S, Kinne DW, et al.: Factors influencing prognosis in node-
negative breast carcinoma: analysis of 767 T1N0M0/T2N0M0 patients with long-term
follow-up. J Clin Oncol 11 (11): 2090-100, 1993. [PUBMED Abstract]
72. Abbott A, Rueth N, Pappas-Varco S, et al.: Perceptions of contralateral breast cancer:
an overestimation of risk. Ann Surg Oncol 18 (11): 3129-36, 2011. [PUBMED
Abstract]
73. Nichols HB, Berrington de González A, Lacey JV Jr, et al.: Declining incidence of
contralateral breast cancer in the United States from 1975 to 2006. J Clin Oncol 29
(12): 1564-9, 2011. [PUBMED Abstract]
74. Heron DE, Komarnicky LT, Hyslop T, et al.: Bilateral breast carcinoma: risk factors
and outcomes for patients with synchronous and metachronous disease. Cancer 88
(12): 2739-50, 2000. [PUBMED Abstract]
75. Graeser MK, Engel C, Rhiem K, et al.: Contralateral breast cancer risk in BRCA1 and
BRCA2 mutation carriers. J Clin Oncol 27 (35): 5887-92, 2009. [PUBMED Abstract]
76. Garber JE, Golshan M: Contralateral breast cancer in BRCA1/BRCA2 mutation
carriers: the story of the other side. J Clin Oncol 27 (35): 5862-4, 2009. [PUBMED
Abstract]
77. Lehman CD, Gatsonis C, Kuhl CK, et al.: MRI evaluation of the contralateral breast
in women with recently diagnosed breast cancer. N Engl J Med 356 (13): 1295-303,
2007. [PUBMED Abstract]
78. Solin LJ, Orel SG, Hwang WT, et al.: Relationship of breast magnetic resonance
imaging to outcome after breast-conservation treatment with radiation for women
with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol
26 (3): 386-91, 2008. [PUBMED Abstract]
79. Morrow M: Magnetic resonance imaging in the breast cancer patient: curb your
enthusiasm. J Clin Oncol 26 (3): 352-3, 2008. [PUBMED Abstract]
80. Simpson JF, Gray R, Dressler LG, et al.: Prognostic value of histologic grade and
proliferative activity in axillary node-positive breast cancer: results from the Eastern
Cooperative Oncology Group Companion Study, EST 4189. J Clin Oncol 18 (10):
2059-69, 2000. [PUBMED Abstract]
81. Rosen PP, Groshen S, Kinne DW: Prognosis in T2N0M0 stage I breast carcinoma: a
20-year follow-up study. J Clin Oncol 9 (9): 1650-61, 1991. [PUBMED Abstract]
16. 82. Diab SG, Clark GM, Osborne CK, et al.: Tumor characteristics and clinical outcome
of tubular and mucinous breast carcinomas. J Clin Oncol 17 (5): 1442-8,
1999. [PUBMED Abstract]
83. Rakha EA, Lee AH, Evans AJ, et al.: Tubular carcinoma of the breast: further
evidence to support its excellent prognosis. J Clin Oncol 28 (1): 99-104,
2010. [PUBMED Abstract]
84. Sørlie T, Perou CM, Tibshirani R, et al.: Gene expression patterns of breast
carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad
Sci U S A 98 (19): 10869-74, 2001. [PUBMED Abstract]
Next section >
Histopathologic Classification of Breast Cancer
Updated: October 30, 2015
This text may be reproduced or reused freely. Please credit the National Cancer Institute as
the source. Any graphics may be owned by the artist or publisher who created them, and
permission may be needed for their reuse.
Want to use this content on your website or other digital platform? Our syndication services
page shows you how.
National Cancer Institute
at the National Institutes of Health
FOLLOW US
Facebook
Twitter
Instagram
YouTube
Google+
LinkedIn
GovDelivery
RSS
CONTACT INFORMATION
Contact Us
LiveHelp Online Chat
MORE INFORMATION
17. About This Website
Cancer.gov en español
Multimedia
Publications
Site Map
Digital Standards for NCI Websites
POLICIES
Accessibility
Comment Policy
Disclaimer
FOIA
Privacy & Security
Reuse & Copyright
Website Linking
U.S. Department of Health and Human Services
National Institutes of Health
National Cancer Institute
USA.gov
NIH ... Turning Discovery Into Health®
TOP