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Source: Michaud LB, Barnett CM, Boster BL. Breast cancer. In: DiPiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM. Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York, NY: McGraw-Hill; 2017. http://accesspharmacy.mhmedical.com/content.aspx?bookid=1861§ionid=146074631. Accessed March 23, 2017.
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Not completely understood.
Current evidence supports concept of carcinogenesis as genetically regulated, multistage process.
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Carcinogenesis includes initiation, promotion, conversion, and progression.
Growth of normal and cancerous cells genetically controlled by balance or imbalance of oncogene, proto-oncogene, and tumor suppressor gene protein products.
Breast cancer cells often spread undetected by contiguity, lymph channels, and through blood early in course of disease, resulting in metastatic disease after local therapy.
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PREVENTION AND SCREENING
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Endocrine:
Genetic.
Environmental (eg, radiation exposure)
See National Cancer Institute risk calculator for interactive risk assessment of multiple factors.
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CLINICAL PRESENTATION
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Painless, palpable lump most common.
Less common:
Pain.
Nipple discharge, retraction, or dimpling.
Skin edema, redness, or warmth.
Palpable local-regional lymph nodes.
Systemic metastasis symptoms depend on site:
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MEANS OF CONFIRMATION AND DIAGNOSIS
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Mammography, with or without ultrasound, breast MRI, or both.
Chest x-ray, chest CT, bone ...