Breast cancer; early and advanced stages

In families with a mutation of the BRCA-1/-2 gene, also called the “breast cancer gene”, the risk of early-onset breast cancer is very high. In general, there is a familial predisposition for certain types of breast cancer even in families that have not got the BRCA-1/-2 gene defect, but breast cancer may also occur randomly in inviduals that have none of the above risk factors. Further risk factors for breast cancer include excess weight, smoking, alcohol abuse, in some cases long-term (several years) hormone therapy, diabetes mellitus, lack of exercise, and first pregnancy at an older age.

Various life style aspects; regular smoking and drinking of alcohol should be cut to a minimum; regular exercise; balanced diet. High-risk patients (familial predisposition) can participate in studies investigating preventive drugs.

Lumps that can be easily felt, and changes in the skin (“orange peel skin”, indentation) are among the late signs of breast cancer. Only imaging procedures such as mammography, high-resolution sonography, and, in some cases, magnetic resonance imaging, will actually allow the early detection of cancerous lumps in the breast.

Mammography, sonography, MRI. Analysing the blood for so-called tumour markers is unsuitable as a diagnostic tool and may therefore be neglected.

Local tumour treatment, preferably by breast-retaining surgery, post-surgery radiation treatment of the remaining mammary gland. Systemic therapy and prevention of tumour cell seeding by means of chemotherapy, hormone therapy and antibody therapy. Appropriate therapy is always based on the patient’s situation and diagnostic findings (the tumour’s biological characteristics) and chosen with her informed consent.