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AccessSurgery's Quick Test lets you test your surgical knowledge and anonymously compare your results to those of your peers. Sign up for our free AccessSurgery e-newsletter and twice a month Quick Test will appear in your email inbox. Quick Test is developed by Gerard M. Doherty, MD, AccessSurgery's Editor-in-Chief, from the site's online resources. Your results will be ranked against those of your peers.
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Quick Test posted on 1.10.12:
| Breast Cancer Therapy
| Curative Treatment
Treatment may be curative or palliative. Curative treatment is advised for clinical stage I, II, and III disease. Patients with locally advanced (T3, T4) and even inflammatory tumors may be cured with multimodality therapy, but in most palliation is all that can be expected. Palliative treatment is appropriate for all patients with stage IV disease and for previously treated patients who develop distant metastases or who have unresectable local cancers.
The growth potential of tumors and host resistance factors vary widely from patient to patient and may be altered during the course of the disease. The doubling time of breast cancer cells ranges from several weeks in a rapidly growing lesion to a year in a slowly growing one. Assuming that the rate of doubling is constant and that the neoplasm originates in one cell, a carcinoma with a doubling time of 100 days may not reach clinically detectable size (1 cm) for about 8 years. Rapidly growing cancers have a much shorter preclinical course and a greater tendency to metastasize by the time a breast mass is discovered.
The long preclinical growth phase and the tendency of breast cancers to metastasize have led clinicians to believe that most breast cancer is a systemic disease at the time of diagnosis. Although it may be true that breast cancer cells are released from the tumor prior to diagnosis, variations in the host-tumor relationship prohibit the growth of disseminated disease in many patients. Clearly, not all breast cancer is systemic at the time of diagnosis. For this reason, a pessimistic attitude concerning the management of breast cancer is unwarranted. Most patients can be cured.
|  | | Sentinel lymph node biopsy helps to guide breast cancer therapy. |
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