DETECTION & DIAGNOSIS / DIAGNOSIS
General advice regarding Diagnosis and treatment:
Woman should consult a doctor who is a known trusted specialist and ask for a correct diagnosis before proceeding with surgery or systemic therapy.
In the presence of a mass or suspicious calcifications, a complete evaluation is necessary. This includes a physical examination, mammography, ultra- sound of breast and axilla, and possibly a breast MRI. Definitive diagnosi is obtained by Ultrasound-guided Core Biopsy which is sent to pathology for tissue diagnosis and Estrogen Receptors (ER), Progesterone Receptors, and HER2/neu (ErbB2) Receptors. FNA of suspicious axillary lymph nodes may be necessary.
Young patients with breast cancer, especially those younger than 40, and those who have a family history of breast or ovarian cancer, those who have Triple Negative Breast Cancer (ER negative PR negative HER2 negative receptors), should have genetic counseling and discussion about doing a blood test for BRCA and Panel gene mutations.
Recent research has shown that young women with curable early breast cancer should be offered the option of having children after treatment and their risk of recurrences remains the same. Oncologists should consult with fertility doctors OB/GYN specialists and have discussion about embryo preservation for married women, or ova preservation. In case those are not available or not suited feasible, then the patient is offered monthly injections of LHRHa to suppress ovarian function and menses, before starting and during chemotherapy. After 3 years of completing treatment and being free of disease, women may be allowed to get pregnant. They should stop anti-hormonal treatment for three months then try pregnancy in consultation with their OB/GYN Fertility Expert. Anti-hormonal treatment to be restarted after delivery.