The stage is an indicator of prognosis and is a guide for therapy. The more advanced the stage, the worse the prognosis. Fortunately, most breast cancers are now detected early. Physical examination and baseline chest x-ray and blood tests determine the clinical stage before any further interventions are done. When initial treatment is completed, the pathological stage can be defined.
Breast cancer treatment has evolved dramatically over the course of the 20th century. An historical review of breast cancer treatment shows a trend toward less invasive diagnostic procedures, less radical surgical treatment, a change in the concept of treatment from a local to a systemic focus, a multidisciplinary team approach, and an increasing number of treatment modialities.
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The first important distinction to be made is whether the cancerous cells have broken through their enclosing membrane and become invasive. Pre-invasive growth of cancer cells within the ducts is called ductal carcinoma in-situ (DCIS). A less common pre-invasive growth of glandular cells is called lobular neoplasia or lobular carcinoma in-situ (LCIS). The latter is not considered a cancer but is poorly understood and does increase the risk for development of cancer in either breast.
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