II. Epidemiology

  1. Incidence: New Cases of Breast Cancer (1997)
    1. Women: 180,200 cases/year
      1. Age <40 years: 7% (12,600 women annually)
      2. Age <50 years: 25% (45,700 women annually)
    2. Men: 1400 cases/year
  2. Mortality from Breast Cancer (1997): 43,900
  3. References
    1. (1997) ACS, Cancer Statistics 1997

III. Risk Factors

IV. Pathophysiology

  1. Breast Cancer is slow growing: 100 day doubling time
  2. Breast Cancer is not detectable for 8-10 years
    1. Year 8: Mammogram identifies 100 billion cell mass
    2. Year 10: Mass palpable on Clinical Breast Exam

V. Exam

VIII. Management: Risk (medical-legal concerns)

  1. Document all Breast complaints
    1. Breast Masses are self diagnosed in 60% of cases
  2. Lawsuit pearls
    1. Premenopausal patients account for 63-68% of suits
    2. Common Allegations
      1. Physical Findings failed to impress
      2. Failure to follow-up with patient
      3. Negative Mammogram report
      4. Mammogram misread
  3. Document any Family History
  4. Compare previous Mammography
  5. Document recommendations for follow-up
  6. Follow documented schedule
  7. Remember to follow up with other consultants
  8. Biopsy palpable mass with negative Mammogram
  9. Pregnancy should not delay diagnostic studies
  10. Most specialties have been named in Malpractice suits
    1. Radiology (24%)
    2. Obstetrics and Gynecology (23%)
    3. Family Practice and General Practice (17%)
    4. Surgery (14%)
    5. Internal Medicine (9%)
    6. Pathology (2%)

IX. Resources

X. Prognosis: Breast Cancer 5 year survival

  1. In Situ (stage 0): 100%
  2. Early invasive (stage I, IIa, IIb)
    1. Local spread: 98%
    2. Regional spread: 83.6%
  3. Locally advanced (stage IIIa-c): 57%
  4. Metastatic (stage IV): 23.4%

XI. References

  1. (1995) Physician Insur Assoc Amer, Breast Cancer Study
  2. Maughan (2010) Am Fam Physician 81(11):1339-46 [PubMed]

Images: Related links to external sites (from Bing)

Related Studies (from Trip Database) Open in New Window

Ontology: Breast Carcinoma (C0678222)

Definition (NCI_NCI-GLOSS) Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.
Definition (NCI) A carcinoma arising from the breast, most commonly the terminal ductal-lobular unit. It is the most common malignant tumor in females. Risk factors include country of birth, family history, menstrual and reproductive history, fibrocystic disease and epithelial hyperplasia, exogenous estrogens, contraceptive agents, and ionizing radiation. The vast majority of breast carcinomas are adenocarcinomas (ductal or lobular). Breast carcinoma spreads by direct invasion, by the lymphatic route, and by the blood vessel route. The most common site of lymph node involvement is the axilla.
Concepts Neoplastic Process (T191)
SnomedCT 286898006, 154513000, 254838004
English CARCINOMA OF BREAST, Carcinoma of breast NOS, carcinoma of breast (diagnosis), carcinoma of breast, breast carcinoma, Breast carcinoma, Breast carcinoma NOS, Carcinoma breast, breast cancer, breast cancer diagnosis, breast carcinomas, Carcinoma of breast NOS (disorder), Breast cancer, NOS, BREAST CANCER, CANCER, BREAST, CA - Carcinoma of breast, Carcinoma of breast, Carcinoma of breast (disorder), Breast Carcinoma, Breast Cancer, Cancer of Breast, Cancer of the Breast, Mammary Carcinoma, Carcinoma of Breast, Carcinoma of the Breast
Dutch borstcarcinoom NAO, carcinoom borst, borstcarcinoom
French Carcinome du sein, Cancer du sein SAI, Carcinome mammaire
German Brustkariznom, Karzinom der Brust, Brustkariznom NNB
Italian Carcinoma mammario NAS, Carcinoma della mammella
Portuguese Carcinoma da mama, Carcinoma da mama NE
Spanish Carcinoma de mama, Carcinoma de mama NEOM, carcinoma de mama, SAI, carcinoma mamario, SAI, carcinoma de mama, SAI (trastorno), carcinoma de mama (trastorno), carcinoma de mama, carcinoma mamario, cáncer de mama
Japanese 乳癌, 乳癌NOS, ニュウガン, ニュウガンNOS
Czech Karcinom prsu NOS, Karcinom prsu, Prsní karcinom
Hungarian Emlő carcinoma, Emlő carcinoma k.m.n., Emlőcarcinoma