Which woman should have genetic testing for mutations related to breast cancer?
It is necessary for a woman who will be tested for mutations to know the implications that a positive answer will have in her life and have decided how she will cope with. The woman who has strong family history should realize that even if the test is negative the risk for breast cancer is still increased for her. It is the breast surgeon at first and finally the genetist who select the women who should be tested.
Is there a risk from the anual mammography radiation?
The danger is minimal and is outweighed by the benefit of early diagnosis of a cancerous or precancerous lesion. The breast surgeon will define the beneficial frequency of mammography for every individual woman.
Is self-breast examination necessary?
The stress added to the daily lives of most women seems that it is not balanced by early diagnosis, provided of course that she visits regularly a breast surgeon.
What is the role of breast magnetic mammography?
When the mammogram and the ultrasound are inconclusive, breast MM may help us to decide if a lesion should be biopsied,. It is imperative to women with prostheses and to mutation carriers. The breast surgeon and radiologist should select on strict criteria the cases that need it, because there are still many false negative or positive results and the MM guided biopsy is not easily performed.
Why the sentinel node biopsy is necessary? When should be done and how?
Axillary’s lymph node clearance frequently causes arm edema and other complaints. Seventy percent of the patients may avoid lymph node clearance and its consequences if the sentinel node is not involved. It is performed by radioisotope injection few hours before the operation combined with blue dye injection just before the operation. This will help the surgeon to choose the right sentinel node for frozen section intraoperatively.
Is the postoperative period difficult to cope with? Is the operation painful?
In general breast operations, if not complicated, cause easily controlled pain with simple pain killers. There are cases, mainly when the axillary’s lymph nodes have been removed, that the drainage tube drains fluid for few days, and the patients must keep it for a short period at home.
When a patient should be submitted to chemotherapy?
In few cases, chemotherapy is necessary before the operation either because there is a very advanced cancer or because we intend to decrease tumor size in order to achieve breast conservation. Chemotherapy is usually administered after the operation to patients with aggressive cancer and before hormonal treatment or when the cancer is not hormone dependent and hormonal treatment has no role to play.
Has breast cancer in young women worse prognosis?
Breast cancer or rather breast cancers, as no cancer is identical to others, have characteristics, which define their aggressiveness. Cancers with similar characteristics have the same prognosis either they appear in young or older women. Young women though, have more often cancers with aggressive behavior and are diagnosed late due to increased breast density.