Aspects of breast cancers

Area of Science:

• Oncology
• Surgical Oncology
• Biomarker Research

Background:

• Breast cancer is a leading cause of mortality in European women, with significant regional variations in mortality rates.
• Early detection and accurate staging are crucial for effective breast cancer treatment.
• Current screening methods, including mammography, have limitations in detecting all malignant diseases.

Purpose of the Study:

• To evaluate the efficacy of the QU.A.R.T. (quadrantectomy, total axillary dissection, and radiotherapy) treatment protocol for early-stage breast cancer.
• To assess the role of clinical examination alongside mammography in breast cancer screening.
• To investigate the utility of specific biomarkers for predicting prognosis and monitoring disease progression in breast cancer patients.

Main Methods:

• Implementation and audit of a standardized quadrantectomy, total axillary dissection, and radiotherapy (QU.A.R.T.) protocol for peripheral T1 and T2 breast tumors.
• Integration of clinical examination with mammography in screening programs, noting limitations of mammography alone.
• Preoperative staging using scintigraphy and sonography.
• Postoperative clinical and biochemical surveillance, including assays for Cathepsin D, CEA, CA15.3, and c-erB-2 protein.

Main Results:

• Complete axillary dissection in early breast cancer provides accurate staging and significantly reduces axillary recurrence.
• Audit of axillary dissection enhances lymph node yield and procedural completeness.
• Clinical examination identified palpable breast cancers missed by mammography in approximately 15% of cases.
• Cathepsin D, CEA, CA15.3, and c-erB-2 protein were identified as valuable markers for disease progression and prognosis.

Conclusions:

• The QU.A.R.T. protocol is an effective treatment for early-stage peripheral breast cancer, with axillary dissection playing a key role in staging and recurrence prevention.
• A combined approach of clinical examination and mammography is recommended for optimal breast cancer screening.
• Biochemical markers such as Cathepsin D, CEA, CA15.3, and c-erB-2 protein offer valuable prognostic information and aid in monitoring treatment response and detecting recurrence.