Breast cancer

Abstract

Breast cancer is the most frequent cancer in women, and although mortality rates have been decreasing in the last 50 years, it remains a leading cause of death in women. This chapter discusses the epidemiology, aetiology, and risk factors for breast cancer including newer genetic factors as well as lifestyle-related issues. Recommendations for screening programmes are made. Investigations include clinical examination and imaging techniques, and diagnosis and treatment decisions are based on staging, which takes account of biological factors such as grade, proliferation rate, receptor status, and HER2 expression as well as extent of disease. Genetic expression profiling contributes to a prognostic stage and various prognostic assays are used to determine appropriate treatment of different tumour types such as luminal A and B, HER2 positive or triple negative cancers. The chapter discusses treatment with surgery, radiotherapy, and adjuvant systemic therapy for the various types of breast cancer. Consideration is also given to treatment of recurrent and metastatic disease, as well as disease in the elderly or very young, in men, and hereditary breast cancer.