ব্রেস্ট ক্যান্সারের আধুনিক চিকিৎসার ধাপ কি কি - Breast Cancer Treatment Bangla

ডা. আলী নাফিসা সহযোগী অধ্যাপক ,সার্জারি, অনকোপ্লাস্টিক ব্রেস্ট সার্জন ট্রেইন্ড ইন অনকোপ্লাস্টিক ব্রেস্ট সার্জারি (ইউকে) কনসালট্যান্ট, ব্রেস্ট সেন্টার ল্যাবএইড ক্যান্সার ও সুপার স্পেসিয়ালিটি হাসপাতাল, ঢাকা মিডিয়া পার্টনার - MediTalk Digital Breast Cancer Stages After someone is diagnosed with breast cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it. Doctors also use a cancer's stage when talking about survival statistics. The earliest stage breast cancers are stage 0 (carcinoma in situ). It then ranges from stage I (1) through IV (4). As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. And within a stage, an earlier letter means a lower stage. Although each person’s cancer experience is unique, cancers with similar stages tend to have a similar outlook and are often treated in much the same way. How is the stage determined? The staging system most often used for breast cancer is the American Joint Committee on Cancer (AJCC) TNM system. The most recent AJCC system, effective January 2018, has both clinical and pathologic staging systems for breast cancer: The pathologic stage (also called the surgical stage) is determined by examining tissue removed during an operation. Sometimes, if surgery is not possible right away or at all, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests. The clinical stage is used to help plan treatment. Sometimes, though, the cancer has spread further than the clinical stage estimates, and may not predict the patient’s outlook as accurately as a pathologic stage. In both staging systems, 7 key pieces of information are used: The extent (size) of the tumor (T): How large is the cancer? Has it grown into nearby areas? The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes? If so, how many? The spread (metastasis) to distant sites (M): Has the cancer spread to distant organs such as the lungs or liver? Estrogen Receptor (ER) status: Does the cancer have the protein called an estrogen receptor? Progesterone Receptor (PR) status: Does the cancer have the protein called a progesterone receptor? HER2 status: Does the cancer make too much of a protein called HER2? Grade of the cancer (G): How much do the cancer cells look like normal cells? In addition, Oncotype Dx® Recurrence Score results may also be considered in the stage in certain situations. Once all of these factors have been determined, this information is combined in a process called stage grouping to assign an overall stage. For more information see Cancer Staging. Details about the first three factors (the TNM categories) are below. However, the addition of information about ER, PR, and HER2 status along with grade has made stage grouping for breast cancer more complex than for other cancers. Because of this, it is best to ask your doctor about your specific stage and what it means. Details of the TNM staging system Numbers or letters after T, N, and M provide more details about each of these factors. Higher numbers mean the cancer is more advanced. The categories below use the pathologic (surgical) definitions. T categories for breast cancer T followed by a number from 0 to 4 describes the main (primary) tumor's size and if it has spread to the skin or to the chest wall under the breast. Higher T numbers mean a larger tumor and/or wider spread to tissues near the breast. TX: Primary tumor cannot be assessed. T0: No evidence of primary tumor. Tis: Carcinoma in situ (DCIS, or Paget disease of the breast with no associated tumor mass) T1 (includes T1a, T1b, and T1c): Tumor is 2 cm (3/4 of an inch) or less across. T2: Tumor is more than 2 cm but not more than 5 cm (2 inches) across. T3: Tumor is more than 5 cm across. T4 (includes T4a, T4b, T4c, and T4d): Tumor of any size growing into the chest wall or skin. This includes inflammatory breast cancer. N categories for breast cancer N followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are involved. Lymph node staging for breast cancer is based on how the nodes look under the microscope, and has changed as technology has gotten better. Newer methods have made it possible to find smaller and smaller groups of cancer cells, but experts haven't been sure how much these tiny deposits of cancer cells influence outlook.