Breast cancer. Challenge and responsibility

The diagnosis and treatment of breast cancer has changed dramatically during the last quarter century, a fact perhaps not fully appreciated by many primary care physicians. Breast cancer presents a number of challenges for the obstetrician/gynecologist. The disease is common and the mortality rate is second only to lung cancer. The appropriate role for the obstetrician/gynecologist is one of surveillance, including taking a history and physical examination and selected diagnostic studies, and as a resource for patients, including a discussion of risk factors and treatment alternatives. Because of the increasing involvement of obstetrics and gynecology in molecular genetics and hormone interactions, basic research in genetic alterations and hormonal therapy directed toward decreasing morbidity from cardiovascular disease and osteoporosis is recommended.