Diagnostic+Tools+and+Treatment+Options

= ** ﻿ Diagnostic Tools ** =

**Mammogram:** x-ray machine, used to detect breast cancer, screening, diagnosis, shows masses, tumors, cysts (circular = benign, erratic = malignant) [|Diagnosis: MRI's beat mammograms Article MBC]
 * **UPDATE:** panel is now urging mammograms at 50 not 40 because of anxiety, unnecessary further tests, unnecessary treatment because some cancers grow so slowly they’ll never be noticed in a woman’s lifetime
 * **MRI:** Magnetic resonance imaging, computers, magnets, look at abnormal areas identified, post surgery, when there’s dense breast tissue, shows extent of tumor
 * **Ultrasound:** transducer, gel, and high freq. Sound waves used, differentiates solid tumor or fluid filled cyst, clarifies a mammogram, shows organs, tissue, pregnancy, evaluates lumps
 * **Biopsy:** surgical tools, needles, ultrasound, x-rays, used to test existing tumors, diagnoses cancer, shows whether something is cancerous or not, as well as the tumor grade
 * **Fine Needle Aspiration:** needle used to draw sample fluid
 * **Core Biopsy:** guided by ultrasound/3D x-ray, tiny incision, core biopsy needle, sample thin tissue
 * **Surgical Biopsy:** samples analyzed by pathologist, sutures-tight stitches to prevent scarring, local anesthetic, remove lump and surrounding tissue

=Grades and Stages= __Tumor Grade__ __Histological Grade__ __Nuclear Grade__
 * How abnormal they look under microscope and how quickly the tumor is likely to grow/spread
 * Differentiation, how much tumor cells resemble normal cells of same tissue type
 * Size/shape of nucleus in tumor cells and percentage of tumor cells dividing [[image:http://w-breastcancer.com/wp-content/uploads/2010/03/stages-of-breast-cancer.jpg align="right"]]

__**Breast Cancer Stages:**__


 * **Stage 0:** carcinoma in situ, cancer confined
 * **Stage 1:** tumor is 2cm or less, no cancer outside of breast
 * **Stage 2:**small and has spread underarm lymphs, lil bit bigger and has not spread that much, or larger but has not spread
 * **Stage 3:** locally advanced,
 * **Stage 4:** metastasized to distant other parts of the body

=Treatment Types= =﻿New Drug to Reduce Development in Breast Cancer= In a clinical trial, a new drug is showing risk of developing breast cancer cut by more than 50% for women of high-risk. It also does not have the side effects of some other drugs currently out there. "It's a very big deal. The results are in essence almost twice as good as the results with tamoxifen and raloxifene," said Dr. William Dooley, University of Oklahoma Physicians surgical oncologist. The trial has been going on for the past three years, and it is uncertain if it actually reduces deaths from breast cancer yet. [|Read the Full Article Here!]
 * **Biological Therapy** || helps immune system fight cancer, uses __monoclonal antibodies: locate and bind to cancer cells__, Trastuzumba and Herceptin (drugs) binds to HER2 positive cells and it slows/stops growth of cancer cells. ** Systemic ,** **Side effects: can stop the heart from beating.** ||
 * **Radiation** || Internal or external, may be used after a mastectomy to kill any remaining cells or used when a lumpectomy is performed **Local** ﻿**Side effects: redness and swelling** ||
 * **Surgery** || most common, 4 types 1.) sparing: lumpectomy with radiation after. 2.) mastectomy (total removal or modified radical. 3.) Lymphnode Biopsy: lymphnodes closest to tumor to test them. 4.) Breast reconstruction: plastic surgery to reshape. ** Local . Side effects: imbalance, back/neck, circulation slows down around lymphnodes.** ||
 * **Chemo** || drug through blood stream, __stops dividing cells,__ pill or injection, ** systemic .** __Risks are weakening of RBC = Leukemia__. **Side effects: fights hair cells and other rapidly dividing ones, nausea, vomiting, fatigue** ||
 * **Hormone Therapy** || __Blocks hormones from reaching tumors,__ cancers don’t use natural hormones that they need, tests on pathology report indicate if this has a high chance of working, Drugs or surgery/ (Tamoxifen is a drug that blocks estrogen). May also have possible removal of ovaries. **Systemic** ||

Structure of Clinical Trials:

 * Clinical Trials:** used to find better ways to prevent, detect, or treat diseases, or to improve care for people with diseases
 * **Phase I:** SAFETY, find safe dose, how it should be given, observe how it affects human body (15-30 people)
 * **Phase II:** see if it has an affect on a __certain cancer__, see how it affects human body (fewer than 100 people)
 * **Phase III:** EFFIC﻿ACY, __compare new and standard treatment__ (100-1000s of people)
 * **Phase IV:** further assess __long-term__ SAFETY AND EFFECTIVENESS of treatment (100s -1000s of people)
 * **Randomization of participants, elimination of bias (double/triple blind structure)**
 * **Control Group:** for cancer, control group receives a standard treatment, the investigational group receives the new treatment, if problems, stop immediately