Current management and treatment strategies for breast cancer

Breast cancer is the most common malignancy in women in the United States and the second most common cause of cancer death in women. This review will focus on the current and clinically relevant recommendations for breast cancer diagnosis, staging, and treatment.

Screening for breast cancer is based on patient history, exam, mammography, and ultrasound. In select patient populations, MRI adds additional detection benefit. Once pathology is found, nipple-sparing mastectomy is felt to be an oncologically well tolerated procedure for both ductal carcinoma in situ and invasive tumors in properly selected patients. Prophylactic mastectomy rates are increasing despite no clear survival benefit. Sentinel lymph node biopsy continues to be the staging procedure of choice, but data are available that completion axillary dissection for a positive sentinel node may not affect outcomes.

Strategies for caring for breast cancer patients continue to evolve. Multiple variables including genetic predisposition, disease burden, tumor markers, receptor status, and patient preference are integral to the decision making for each individual patient.