Breast Cancer

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Photo by Miguel Á. Padriñán on

1/8 Women will develop breast cancer.

Breast Cancer: Biennial screening

50-74 years: mammography

over 75 years: Insufficient evidence to recommend mammography.

If you want to discuss mammography orders, please visit our clinic.

But the general guidelines are:

Essential elements of management for breast cancer survivors who have completed active treatment and have no evidence of disease are cancer surveillance, encouragement of adherence with ongoing treatment and lifestyle recommendations, treatment of medical and psychosocial consequences of cancer and its therapy, and care coordination between specialists and primary care providers.

Survivor follow-up should include updated history, regular physical examination, and breast imaging (ie, mammography). The follow-up should not only focus on cancer surveillance, but also on any late-treatment related complications, psychosocial issues, and occupational problems.

All women with breast cancer should be counseled about the role of genetic testing and counseling.

Laboratory studies or radiologic imaging to screen for distant recurrence in asymptomatic patients should not be performed.

All breast cancer survivors should pursue a healthy lifestyle that includes following a prudent diet, pursuing or maintaining an active exercise program, minimizing alcohol intake, and refraining from smoking.

Treatment may affect many aspects of sexuality, and breast cancer survivors should be routinely questioned about concerns related to sexual health and counseled or referred as needed.

Although data are limited, studies do not indicate increased risk of recurrence for survivors who become pregnant or an impact on pregnancy outcomes.

For women with breast cancer who wish to preserve fertility but delay pregnancy, we suggest not administering hormonal contraception . Physicians should counsel women about methods most consistent with their lifestyle and beliefs. Alternative forms of contraception include copper IUD and barrier methods.

A variety of clinicians may adequately follow women after their primary therapy for breast cancer. Clinicians should be experienced in the surveillance of these patients, the complications that may arise from treatment, and in breast examination, including the examination of irradiated breasts. A shared care model that integrates both specialists and primary care providers on ongoing follow-up care may provide the best adherence to guidelines for recommended care; but communication and coordination of care is required.

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