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16 - Breast

Published online by Cambridge University Press:  23 December 2009

By
Nayyer Iqbal  and
Peter Barrett-Lee
Edited by
Louise Hanna ,
Tom Crosby  and
Fergus Macbeth
Nayyer Iqbal
Affiliation:
Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Peter Barrett-Lee
Affiliation:
Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Louise Hanna
Affiliation:
Velindre Hospital, Cardiff
Tom Crosby
Affiliation:
Velindre Hospital, Cardiff
Fergus Macbeth
Affiliation:
Velindre Hospital, Cardiff
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Summary

Introduction

The lifetime risk of breast cancer in women is one in nine. Breast cancer most commonly presents as a lump in the breast, but the use of screening has also allowed very early cancers to be diagnosed before they can be detected clinically. The management of breast cancer has changed dramatically. In the past, patients were treated with radical mastectomy, whereas today, patients are usually treated with breast-conserving techniques – wide local excision and radiotherapy. The past few decades have also seen the wider use and development of systemic therapies: hormonal treatments, chemotherapy and, recently, the monoclonal antibody trastuzumab. As a result, there has been a steady fall in the mortality from breast cancer.

Types of tumour affecting the breast

Table 16.1 shows the range of tumours that can affect the breast.

Anatomy

The female breast extends from the 2nd to the 6th rib, and it is made up of 15 to 20 lobes which radiate out from the nipple. The nipple is surrounded by the areola. Each breast is divided into a central portion and four quadrants. The upper outer quadrant also contains the axillary tail. The lymphatic drainage from the breast is primarily to the axillary lymph nodes but also to the internal mammary nodes, which lie in the thorax alongside the internal thoracic artery. A few lymphatic channels also communicate with those in the opposite breast and in the abdominal wall.

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Practical Clinical Oncology , pp. 190 - 213
Publisher: Cambridge University Press
Print publication year: 2008

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  • Breast
    • By Nayyer Iqbal, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Peter Barrett-Lee, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.017
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  • Breast
    • By Nayyer Iqbal, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Peter Barrett-Lee, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.017
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  • Breast
    • By Nayyer Iqbal, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Peter Barrett-Lee, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.017
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