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Chapter 14 - Breast Cancer

Published online by Cambridge University Press:  23 October 2024

By
Giancarlo Moscol ,
Melissa Mitchell  and
Rosa F. Hwang
Edited by
Laurie J. Mckenzie  and
Denise R. Nebgen
Laurie J. Mckenzie
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
Denise R. Nebgen
Affiliation:
University of Texas MD Anderson Cancer Center, Houston
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Summary

Breast cancer is the second most common malignancy in women worldwide. Due to improvements in screening, diagnosis, endocrine therapy and novel targeted agents, survival continues to increase. The initial workup should include thorough imaging of the breast and nodal basins, pathologic review, receptor status analysis and systemic staging as necessary. This information is fundamental to determine the best options for surgery, systemic therapy and radiation therapy and in addition, the most appropriate sequence of multimodal therapy. Care of patients with germline mutations should include genetic counseling and consideration of prophylactic mastectomy and salpingo-oophorectomy. Recent advances in immunotherapy, targeted agents and antibody drug conjugates improve survival and quality of life for metastatic breast cancer patients while limiting toxicity. Surgical techniques have evolved to allow more patients to undergo breast conservation and to limit morbidities from axillary node dissections. New genomic predictive assays allow us to select high risk patients who will truly benefit from chemotherapy and radiation therapy. Modern radiation approaches can limit toxicities by using hypofractionation, partial breast irradiation, 3D conformal planning and proton therapy. The optimal treatment of breast cancer patients requires a multidisciplinary approach tailored to the individual patient in order to maximize clinical outcome and minimize toxicities.

Keywords

ER+ breast cancertriple negative breast cancerHer2 positive breast cancerHer2 lowneoadjuvant chemotherapyendocrine therapygermline mutationBRCA1/2 mutationadjuvant radiation
Type
Chapter
Information
Caring for the Female Cancer Patient
Gynecologic Considerations
 , pp. 227 - 257
Publisher: Cambridge University Press
Print publication year: 2024

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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

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