Definition: Breast carcinoma refers to malignant tumours originating from breast tissue, the most common being ductal and lobular carcinomas. Epidemiology: Most common cancer in women in the UK. Risk factors include age, female gender, family history, BRCA1/BRCA2 mutations, early menarche, late menopause, and hormone replacement therapy (HRT). Classification: Invasive ductal carcinoma (most common). Invasive lobular carcinoma. Ductal carcinoma in situ (DCIS). Lobular carcinoma in situ (LCIS). Other rarer subtypes. Clinical Presentation: Painless breast lump (most common). Nipple discharge, retraction, or eczema-like changes. Skin dimpling or “peau d’orange” appearance. Swelling and inflammation in inflammatory breast cancer. Investigations: Mammography: Gold standard imaging for women over 35. Ultrasound: Useful in younger women with dense breast tissue. Core biopsy or fine needle aspiration: For histological diagnosis. MRI: In selected cases, especially for those with BRCA mutations or dense breasts. Management: Surgery: Lumpectomy or mastectomy, often with sentinel lymph node biopsy or axillary dissection. Radiotherapy: Often post-lumpectomy or after mastectomy in certain cases. Chemotherapy: Depending on tumour size, grade, lymph node involvement, and other factors. Hormonal therapy: e.g., tamoxifen or aromatase inhibitors for hormone receptor-positive cancers. Targeted therapies: e.g., trastuzumab for HER2-positive tumours. Prognosis: Depends on stage at diagnosis, grade, lymph node involvement, and molecular characteristics. Early detection improves prognosis significantly. Screening: The NHS Breast Screening Programme offers mammography every three years to women aged 50-70, with the age range set to expand to 47-73.
