Treatment Guidelines

Screening of breast cancer has proved to substantially reduce mortality. Data from controlled randomized clinical trials show that selective estrogen receptor modulators (SERMs) tamoxifen or raloxifene-based treatment reduces the risk of breast cancer in women who are at high risk for the disease. There is no data to prove that SERM reduces breast cancer-related mortality. Therefore, this strategy cannot be considered as a standard of care. It should only be used with individuals at high risk as it can only reduce the incidence of new primary breast cancers. High risk groups include people aged over 60 years, people with a history of lobular carcinoma in situ, ductal carcinoma in situ, atypical proliferative lesion of the breast, and Individuals with BRCA 1 and 2 mutations.

A bimanual palpation of breast and locoregional lymph nodes is recommended. A radiological examination should be done which may include bilateral mammography and ultrasound of breasts and regional lymph nodes. MRI of breast is not needed as a routine test. A pathological diagnosis involving a core needle biopsy is recommended before surgery. If pre-operative chemotherapy is planned, a core needle biopsy with placement of surgical clips into the tumor should be done to facilitate surgical resection later.