Cancer Stories

Breast Cancer Evaluation

August 15th, 2005

Breast cancer incidence
Breast cancer is one of the most important diseases for women in the United States and constitutes one fourth of all cancers in females, making it the most common cancer in females. Breast cancer develops in as many as 1 in 8 women by the time they are aged 80 years and is 100 times less common in men. Breast cancer accounts for approximately 15% of female cancer deaths. Approximately 182,800 new cases per year occur in the United States, causing 40,800 deaths per year. Breast cancer is the leading cause of death in women aged 44-50 years. The 5-year survival rate is 60% overall but is greater than 80% for early disease.
Approach to evaluation
As with all clinical conditions, approach breast cancer evaluation in the systematic way learned at the start of clinical training, namely with an ordered inquiry beginning with symptoms and general clinical history, followed by clinical examination and, finally, investigation, which can include imaging and ultimately biopsy. This approach naturally lends itself to a gradually increasing degree of invasiveness, so that when a diagnosis is obtained, the process can be stopped with the minimum amount of invasion and, consequently, minimum discomfort to the patient. Because the more invasive investigations also tend to be the most expensive, this approach is usually the most economical.
Evaluation goals
The aims of evaluation of a breast lesion are to judge whether surgery is required and, if so, to plan the most appropriate surgery. Therefore, the ultimate goal is to achieve the most appropriate degree of breast conservation while minimizing the need for reoperation.
Triple assessment
In breast cancer, the general approach to evaluation has become formalized as triple assessment, involving clinical examination, imaging (usually mammography and/or ultrasound), and needle biopsy, but always perform this as part of a more general assessment beginning with clinical history.

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Entry Filed under: EDUCATION