Breast cancer is a complex disease and treatment recommendations are continually changing. It is the leading cancer in women and the second leading cause of cancer mortality. This overview of breast cancer will discuss pathologic features, local and systemic treatment considerations, endocrine therapy, metastatic treatment regimens, and follow-up for optimal breast health. Recent approvals that advance the treatment of metastatic breast cancer are also addressed.
The number of cancer survivors has steadily climbed to more than 10 million since the 1980s secondary to advances in detection and treatment modalities. This reality, combined with an aging population, has drawn the attention of the medical community to meet the needs of this population. Therefore, cancer care providers are being called to develop survivorship programs for patients with curable disease. Some of the prominent organizations supporting this movement for focused survivorship care include the Institute of Medicine, the National Comprehensive Cancer Network, the American Society of Clinical Oncology, LiveStrong™, and the Oncology Nursing Society. This article provides the necessary steps for the development and implementation of an institution-specific survivorship program to fulfill the new standards for survivorship care.
In addition to the benefits of receiving a diagnosis at earlier stages, with smaller tumors and node negativity, patients with breast cancer undergoing screening mammography aged 40-49 years are less likely to require chemotherapy and its associated morbidities. The majority of high-risk lesions were diagnosed in the screened group, which may lead to the benefit of chemoprevention, lowering their risk of subsequent breast cancer, or screening with MRI, which may diagnose future mammographically occult malignancies.
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