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Breast Cancer Mx
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Depends on stage, tumour type and pt background ''Surgery'' Offered to most pts (not frail elderly with mets) WLE - solitary, peripheral, small lesion in large breast, DCIS <4cms Mastectomy - multifocal, central, large lesion in small breast, DCIS >4cms +/- reconstruction - immediate or delayed ''Radiotherapy'' recommended post WLE post mastectomy if T3-T4 or 4+ LN ''Chemotherapy'' Pre or post surgery to downstage tumour or adjuvant ''Biologics'' Trastuzumab (Herceptin) - only for HER2 positive - cannot be used if Hx of heart disease ''Hormonal'' Offered if hormone receptor positive Tamoxifen if pre-men for 5 yrs post diagnosis ?longer - SE - endometrial ca, VTE, menopausal Sx Aromatase inhibitors if post men (aromatisation leads to oestrogen production peripherally).
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