REVIEW   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 June;178(6):459-65

DOI: 10.23736/S0393-3660.18.03870-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Advances in breast cancer treatment

Damir GREBIĆ ¹ ✉, Daniel V. ŠIMAC ², Petra VALKOVIĆ ³

¹ Department of General and Oncological Surgery, Clinical Hospital Centre Rijeka, School of Medicine, University of Rijeka, Rijeka, Croatia; ² Department of Hematology, Rheumatology and Clinical Immunology, Rijeka Clinical Hospital Center, Rijeka, Croatia; ³ Department of Radiology, Clinical Hospital Centre Rijeka, School of Medicine, University of Rijeka, Rijeka, Croatia

Breast cancer is the most common malignant tumour in women worldwide. Morbidity and mortality increases with age, significantly after the age of 45. Early detection of the disease is vital. The diagnosis and treatment of breast cancer today is significantly advanced. Magnetic resonance imaging has revolutionised diagnostics. If a biopsy shows invasive lobular carcinoma or even ductal carcinoma in situ, it is necessary to perform an magnetic resonance scan to rule out multicentricity or an extensive intraductal component, which may affect the surgical approach. Prognosis and treatment of breast cancer today depends on four molecular subtypes: Luminal A, luminal B, HER2-positive, and triple negative. Guidelines for surgical and oncological treatment today have also changed, patients with locally or systemically advanced breast cancer, with a tumour larger than 2.5 cm, confirmed as HER-2 positive or triple negative from biopsy results, should be subjected to neoadjuvant chemotherapy, and after the tumour is reduced, to surgery, at which point the operation can be considerably less involved than before. Furthermore, in the case of a positive sentinel lymph node, formerly mandatory axillary dissection can be replaced by axillary radiotherapy today with comparable prognosis and survival rate. Of new surgical techniques, skin-sparing mastectomy is worth mentioning, while intraoperative radiotherapy will be the future of treatment. The diagnosis and treatment of breast cancer has been significantly advanced. This review have revealed the current treatment of breast cancer on surgical, oncological fiels as well as in diagnosis.

KEY WORDS: Breast neoplasms; Magnetic resonance imaging; Neoadjuvant therapy; Mastectomy