Treatment of breast cancer by Dr.Syed Alam Zeb

Treatment of breast cancer Dr.Syed Alam Zeb

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Staging ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Staging (cont) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Staging (cont) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Staging (cont) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Breast cancer is commonly treated by various combinations of: ,[object Object],[object Object],[object Object],[object Object]

Prognosis and selection of therapy may be influenced by: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Since criteria for menopausal status vary widely, some studies have substituted age older than 50 years as a surrogate for the postmenopausal state.

Patient management following initial suspicion of breast cancer generally includes: ,[object Object],[object Object],[object Object],[object Object]

Ductal Carcinoma In Situ ,[object Object],[object Object],[object Object],[object Object]

Treatment options for DCIS ,[object Object],[object Object],[object Object]

Lobular Carcinoma In Situ ,[object Object],[object Object]

Treatment of Lobular Carcinoma In Situ ,[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment options for patients with LCIS ,[object Object],[object Object],[object Object],[object Object]

Management of Stage I, II, IIIA, and Operable IIIC Breast Cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Locoregional therapy ,[object Object],[object Object],[object Object]

Options for surgical management of the primary tumor include: ,[object Object],[object Object],[object Object]

Selection of a local therapeutic approach depends on: ,[object Object],[object Object],[object Object],[object Object],[object Object]

relative contraindications to breast-conserving therapy ,[object Object],[object Object],[object Object],[object Object]

surgical techniques used include: ,[object Object],[object Object],[object Object]

Which option? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dealing with axillary lymph nodes ,[object Object],[object Object],[object Object]

Sentinel lymph node biopsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Radiation therapy ,[object Object],[object Object]

Radiation therapy following Breast conservation ,[object Object],[object Object],[object Object],[object Object]

Radiation therapy following mastectomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Adjuvant systemic therapy ,[object Object],[object Object],[object Object]

Hormone therapy ,[object Object],[object Object],[object Object]

Tamoxifen ,[object Object],[object Object],[object Object],[object Object]

Tamoxifen toxic effects ,[object Object],[object Object],[object Object],[object Object]

Aromatase inhibitors: anastrozole ,[object Object]

Aromatase inhibitors: exemestane ,[object Object],[object Object],[object Object]

Aromatase inhibitors: letrozole ,[object Object],[object Object],[object Object]

Ovarian Ablation ,[object Object],[object Object]

Chemotherapy ,[object Object],[object Object]

Duration of CMF-based chemotherapy ,[object Object]

Anthracycline based chemotharapy ,[object Object],[object Object]

Role of Preoperative adjuvant chemotherapy ,[object Object]

Monoclonal antibodies ,[object Object],[object Object]

Risk Categories for Women With Node-Negative Breast Cancer Low risk (has all listed factors) Intermediate risk High risk (has at least 1 listed factor) Tumor size ≤ 1cm 1-2 cm >2 cm ER or PR Status positive positive negative Tumor grade Grade 1 grade 1-2 grade 2-3

Adjuvant systemic treatment for node negative premenopausal women Patient group Low risk Intermediate risk High risk ER-positive or PR-positive None or tamoxifen 1.T ± C 2.Ov Ab 3.GnRH analog ,[object Object],[object Object],[object Object],[object Object],[object Object],ER-negative or PR-negative — — Chemotherapy

Adjuvant systemic treatment for node negative postmenopausal women Patient group Low risk Intermediate risk High risk ER-positive or PR-positive None or tamoxifen T ± C T ± C ER-negative or PR-negative — — Chemotherapy Older than 70 years None or tamoxifen T ± C T. Consider chemotherapy if ER-negative or PR-negative

Adjuvant systemic treatment for node positive premenopausal women Patient group Treatments ER or PR-positive ,[object Object],[object Object],[object Object],[object Object],[object Object],ER-negative or PR-negative Chemotherapy

Adjuvant systemic treatment for node positive postmenopausal women Patient group Treatments ER or PR-positive T ± C ER-negative or PR-negative Chemotherapy Older than 70 years Tamoxifen alone; consider chemotherapy if receptor-negative

Candidates for whom adjuvant therapy may not be necessary ,[object Object],[object Object]

Inoperable stage IIIB or IIIC or inflammatory breast cancer ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stage IV breast cancer ,[object Object],[object Object]

Stage IV breast cancer (cont) ,[object Object],[object Object]

Stage IV breast cancer (cont) ,[object Object],[object Object],[object Object]

Follow-up ,[object Object],[object Object]

Treatment of breast cancer by Dr.Syed Alam Zeb

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Treatment of breast cancer by Dr.Syed Alam Zeb