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Breast cancer

Carcinoma mammae · Rakovina prsu

What it is

The commonest cancer in women; survival now exceeds 85% at five years in screened populations.

Symptoms & signs

  • Painless lump
  • skin dimpling
  • nipple inversion or discharge
  • breast shape change
  • armpit lump

🚩 Get help if…

  • see a doctor soon A new lump in the breast or armpit
  • see a doctor soon Skin dimpling, puckering or orange-peel look
  • see a doctor soon Nipple turning inwards, a rash on it or bloody discharge
  • see a doctor soon Bone pain, cough or breathlessness after breast cancer

Where it strikes

Medical treatment

  • Lumpectomy or mastectomy
  • sentinel node biopsy
  • radiotherapy
  • endocrine therapy (tamoxifen, aromatase inhibitors)
  • trastuzumab for HER2
  • CDK4/6 inhibitors
  • chemotherapy
  • trastuzumab deruxtecan (Enhertu) — approved for HER2-positive and HER2-low spread disease; lung inflammation is its serious harm
  • pembrolizumab with chemotherapy before and after surgery for high-risk early triple-negative cancer — approved (FDA 2021, EMA 2022)

Natural & lifestyle

  • Exercise 3–5 h a week — lower recurrence in cohort studies mixed evidence
  • Less alcohol mixed evidence
  • Weight control mixed evidence
  • Breastfeeding mixed evidence
  • Screening from 50 — per 1 000 women screened for 20 years, about 4 breast-cancer deaths avoided and about 13 over-diagnosed and treated for a cancer that would never have surfaced (UK Independent Review, 2012) mixed evidence

Emerging & experimental

  • CtDNA-guided escalation
  • risk-adapted screening

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture for aromatase-inhibitor joint pain — a large trial (SWOG S1200) found less pain trials support
  • Mistletoe extract — quality-of-life benefit in some studies, no proven survival benefit mixed evidence
  • Fasting-mimicking diet around chemotherapy (DIRECT trial) — better tumour response in those who kept to it early / small studies
  • Avoiding soy — once advised; large studies link normal soy intake to fewer recurrences not confirmed in trials
  • Gerson therapy (juices and coffee enemas) — no evidence of benefit anecdotal / traditional

ICD codes