3 results
19 - Management of cancer of the breast
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- By Delia Pudney, South West Wales Cancer Centre, Singleton Hospital, Swansea, UK, James Powell, Velindre Cancer Centre, Velindre Hospital, Cardiff, UK, Jacinta Abraham, Velindre Cancer Centre, Velindre Hospital, Cardiff, UK, Nayyer Iqbal, Velindre Cancer Centre, Velindre Hospital, Cardiff, UK
- Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
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- Book:
- Practical Clinical Oncology
- Published online:
- 05 November 2015
- Print publication:
- 19 November 2015, pp 262-292
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- Chapter
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Summary
Introduction
Breast cancer accounts for 7% of all deaths from cancer and 15% of female deaths from cancer. It is the second most common cause of cancer death among women in the UK. 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 significantly over the past 50 years. Standard surgery used to be radical mastectomy and axillary node clearance, whereas today, patients are usually treated with breast-conserving techniques: wide local excision and sentinel lymph node biopsy followed by radiotherapy. The past few decades have also seen the development and wider use of systemic therapies: hormonal treatments, chemotherapy and targeted therapies such as trastuzumab. The mortality from breast cancer has steadily decreased over the last 20 years.
Anatomy
The female breast extends from the second to the sixth rib, and it is made up of 15–20 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.
In the male and prepubertal female, the nipple and areola are small, and the breast tissue does not usually extend beyond the areola.
Types of tumour affecting the breast
Table 19.1 shows the range of tumours that can affect the breast. The most common are invasive ductal carcinoma and invasive lobular carcinoma. Invasive ductal carcinomas are positive for E-cadherin, whereas lobular carcinomas are negative for E-cadherin.
Incidence and epidemiology
Breast cancer is the most common malignancy in women in the UK and accounts for 30% of all new cancers in women. In 2011 there were 50,285 new cases of breast cancer in the UK, with 349 of these occurring in men.
16 - Breast
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- 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
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- Book:
- Practical Clinical Oncology
- Published online:
- 23 December 2009
- Print publication:
- 24 January 2008, pp 190-213
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- Chapter
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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.
The use of simple sequence repeat (SSR) markers to identify and map alien segments carrying genes for effective resistance to leaf rust in bread wheat
- Nayyer Iqbal, Firdissa Eticha, Elena K. Khlestkina, Annette Weidner, Marion S. Röder, Andreas Börner
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- Journal:
- Plant Genetic Resources / Volume 5 / Issue 2 / August 2007
- Published online by Cambridge University Press:
- 01 August 2007, pp. 100-103
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- Article
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Aegilops markgrafii is a useful source of genes encoding both resistance to biotic stress and high seed lysine content. Bread wheat/Ae. markgrafii introgression lines expressing leaf rust resistance were developed from a cross between a leaf rust-resistant Ae.markgrafii accession and the susceptible bread wheat cultivar ‘Alcedo’. The content of introgressed segments present in five sister introgression lines was assessed with the help of chromosome-specific simple sequence repeats (SSRs). One of the lines was used as a parent of a 140 individual F2 mapping population, by crossing with the leaf rust-susceptible bread wheat cv. ‘Borenos’. The population was tested for susceptibility or resistance to leaf rust, and linkage analysis indicated the presence of a quantitative trait locus (QLr.ipk-2A) originating from the Ae. markgrafii parent, mapping to the distal segment of chromosome arm 2AS.