HTHSCI 1DT3 Lecture Notes - Lecture 9: Fibrous Cap, Calcification, Thrombolysis
26 Dec 2020
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Manage in an mdt c an individual approach. Try to enrol pts. in a trial. Wle + radiotherapy (80% treated like this) Same survival, but wle has recurrence rates. Sn = first node that a section of breast drains to. If clinically ve axillary lns, no need for further dissection if sn is clear. Blue dye / radiocolloid injected into tumour. Visual inspection / gamma probe @ surgery to id sn. Sn removed and sent for frozen section. If node +ve axillary clearance or radiotherapy. 2 rcts compared snb vs. snb + axillary clearance. No differences in overall or disease-free survival. Guides appropriate adjuvant systemic therapy (0. 2 x tumour size) + histo grade + nodal status. Post-mastectomy: only if high risk of local recurrence. Pre-menopausal, node +ve, high grade or recurrent tumours. Neo-adjuvant chemo improves survival in large tumours. Used in er or pr +ve disease: recurrence, survival. Serm: antagonist @ breast, agonist @ uterus.
