Breast Cancer

Breast Cancer

Breast cancer has recently been identified as the most commonly diagnosed cancer type. It is treated in a multidisciplinary treatment scheme since it is a disease treated jointly by Pathology, Breast Surgery, Medical Oncology and Radiation Oncology specialists from the diagnosis stage to treatment.

Breast cancer is a disease that is rarely diagnosed with a palpable mass today, especially due to the widespread use of mammography screening over the age of 40, it is often detected in early stages such as DCIS without being directly diagnosed as cancer and its treatment is different. In the first stage of diagnosis, a thick needle biopsy called tru-cut or core biopsy is performed after a palpable mass or a suspicious appearance on imaging.

After the diagnosis stage, staging is performed to determine how treatment will start. Staging in breast cancer is done in different ways, taking into account clinical, pathological and chemotherapy response criteria. After staging, which is based on the guidelines published by the ACJJ, a US organization, it is evaluated which of the drug (chemotherapy-smart drug) and surgery options will be used in the first plan.

Especially in the first applications of the patients, if the diagnosis stage has been passed, I hear statements such as “what is my stage?” or “they told me stage 2, they told me stage 3.” In general, no matter how important clinical staging is in breast cancer, it is not considered sufficient alone today. It is not possible to talk about the staging of patients without genetic staining such as hormone and HER2 in biopsies. Again, since I also take a needle biopsy from the armpit in most patients, you can consider pathological staging (postoperative staging) and clinical staging as intertwined. For this reason, I recommend that you do not get confused especially in terms of staging and leave this part to your doctor.

The groups we separate in terms of staging:

Early stage breast cancer: the patients we operate most of the time in the foreground

Locally advanced breast cancer: patients in the foreground, for whom we often perform preoperative chemotherapy

Metastatic patients at the time of admission: patients in whom we always apply chemotherapy in the foreground if there are no problems such as open wound-infection in the breast

as follows. However, as I said, it is always better to leave the staging part to your doctor and not to confuse yourself about staging. The confusion, sadness, stress, anxiety that I have seen in all my patients during the initial diagnosis of breast cancer increases the confusion about staging.