Management of breast cancer: basic principles

Breast cancer is the commonest cancer in the United Kingdom. Its incidence is increasing and although mortality from the disease is decreasing it still accounts for over 10,000 deaths a year. All women referred with breast symptoms should undergo triple assessment with clinical examination, radiological imaging and a biopsy of any abnormality found. The treatment of patients with breast cancer should be multidisciplinary and all patients should be discussed and treatment plans formulated at regular multidisciplinary meetings. Patients with breast cancer are usually treated surgically and may have a range of surgical options open to them, although for the majority this will involve breast-conserving surgery or mastectomy. A lymph node staging procedure is also performed for invasive cancers to guide the use of adjuvant therapy and achieve loco-regional disease control. Unless there is preoperative evidence of involved axillary lymph nodes this should take the form of a sentinel lymph node biopsy. Throughout the course of treatment, patients should have access to dedicated breast care nurses to help explain treatment options further, answer questions, and allay any fears they may have.