The document discusses various methods for classifying, staging, and treating breast cancer, including surgery, radiation therapy, hormone therapy, chemotherapy, and monoclonal antibodies. Treatment options depend on factors like cancer type and stage, age, hormone receptor status, and menopausal status. Guidelines are provided for adjuvant systemic treatment based on node status and other risk factors for both premenopausal and postmenopausal women.

1. Treatment of breast cancer Dr.Syed Alam Zeb

9. Since criteria for menopausal status vary widely, some studies have substituted age older than 50 years as a surrogate for the postmenopausal state.

41. Risk Categories for Women With Node-Negative Breast Cancer Low risk (has all listed factors) Intermediate risk High risk (has at least 1 listed factor) Tumor size ≤ 1cm 1-2 cm >2 cm ER or PR Status positive positive negative Tumor grade Grade 1 grade 1-2 grade 2-3

43. Adjuvant systemic treatment for node negative postmenopausal women Patient group Low risk Intermediate risk High risk ER-positive or PR-positive None or tamoxifen T ± C T ± C ER-negative or PR-negative — — Chemotherapy Older than 70 years None or tamoxifen T ± C T. Consider chemotherapy if ER-negative or PR-negative

45. Adjuvant systemic treatment for node positive postmenopausal women Patient group Treatments ER or PR-positive T ± C ER-negative or PR-negative Chemotherapy Older than 70 years Tamoxifen alone; consider chemotherapy if receptor-negative