Download Breast CANCER

SGPGIMS, Lucknow, India
Why is SGPGIMS Lucknow an ideal Hospital for
state-of-the-art treatment of Breast Cancer
Gaurav Agarwal / Jul 2008
Breast Cancer is best treated in a Multi Disciplinary
Manner by a team of experts. All components of such an
expert team are available under one roof at SGPGIMS
Lucknow
Breast
Surgeon
Radiologist
Radiation Oncologist
SGPGIMS
Nuclear Medicine
Medical Oncologist
Pathologist
Gaurav Agarwal / Jul 2008
How is Breast Cancer Managed at SGPGIMS Lucknow,
and at major eminent centers around the world
Suspected Breast Cancer
Confirmation of Diagnosis
Staging
Early Operable
Locally Advanced
Metastatic
Treatment
Surgery, CTx, RTx, HTx
Follow-up
Identify Recurrence
Secondary treatment
Complications
Gaurav Agarwal / Jul 2008
Staging Breast Cancer is an important initial step in deciding
appropriate treatment for an individual patient
Patients are staged into three major groups according to stage of
disease. The approach to treatment and expected outcomes are
very different in these three groups
Early Operable Breast
Cancer
Curable
Potentially Curable
Locally
Advanced
Br Ca
Gaurav Agarwal / Jul 2008
In-curable
Metastatic
Br Ca
What are the Treatment Modalities
used for treatment of breast cancer
For Loco-regional control- i.e. treating the primary cancer in breast
and regional disease in lymphatic basin of axilla (arm-pit)
• Surgery
• Radiation therapy
For Systemic control- i.e. for control of invisible (in early stage
cancers) or evident (late stage) disease outside the breast and
arm-pit
• Cyto-toxic chemotherapy
• Hormonal therapy
• Immuno-therapy/ other biologicals
Almost all modalities are required in almost all patients, though with
different intention, and in different sequence
Gaurav Agarwal / Jul 2008
What is an appropriate sequence of
various components of Breast
cancer Treatment: this varies
according to stage groups
Biopsy: Cytologic/ histologic Confirmation
Staging
Early Operable
Locally Advanced
Metastatic
Operation
Neo-adjuvant
Chemotherapy
Primary/ salvage
Systemic Tt
Adjuvant Tt- chemotherapy,
radiation, hormone
Surgical Tt
?Surgical Tt
Follow-up
Adjuvant Tt
Follow-up
Follow-up
Gaurav Agarwal / Jul 2008