Senior Consultant, Surgical Oncology, Fortis Hospital, Noida
Series overview · 9 articles
Diagnosis and Management of Breast Cancer
November 17, 2024
Breast cancer accounts for roughly 11.5% of all cancers diagnosed worldwide, and Africa contributes about 8.6% of the global breast cancer burden. Dr. Jalaj Baxi, Senior Consultant, Surgical Oncology at Fortis Hospital, Noida, used his Jivo Masterclass to walk referring doctors across Africa through how the disease presents, how it is diagnosed, and how treatment decisions are actually made once a diagnosis is confirmed.
Why this session matters for a referring doctor
The session was deliberately built around diagnosis and management rather than the finer detail of oncological treatment, aimed at general physicians and referring doctors rather than oncology specialists. The goal was to make clear what a breast lump, a nipple change, or an incidental finding should trigger, and where the case goes from there.
What this series covers
This series works through how breast cancer presents and who should be worked up, the triple assessment of clinical, radiological, and pathological evaluation, the biopsy techniques used to confirm a diagnosis and the receptor testing that follows, how staging and tumor biology together decide the treatment sequence, the choice between breast conservation and mastectomy, how the axilla is managed, when radiation therapy is added, and how chemotherapy, hormonal therapy, and targeted therapy are used, including in metastatic disease.
This article is based on a Jivo Masterclass session conducted by Dr. Jalaj Baxi, Senior Consultant, Surgical Oncology, Fortis Hospital, Noida. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
Looking for a breast cancer consultation or a second opinion? Get in touch with the Jivo team
This guide is based on a live Jivo Masterclass: Dr. Jalaj Baxi taught doctors across Africa on November 17, 2024.
Watch the full recording, or read the guide above.
FROM THE LIVE Q&A
Moderator
In what situations is prophylactic mastectomy appropriate in early-stage breast cancer?
Dr. Jalaj Baxi
Only in patients with a genetically determined risk, specifically those who test positive for BRCA1 or BRCA2 mutations. BRCA testing itself is only done when there is a family history of breast cancer.
Frequently Asked Questions
What modalities help prevent reactions to anti-cancer drugs and reduce mortality during chemotherapy?▼
Mortality in chemotherapy is a fairly rare event, and when it happens it is almost always due to bone marrow suppression. The key is giving chemotherapy under close supervision so that this suppression is caught early, since early detection is what actually prevents mortality.
How does surgery compare with radiotherapy for local control in advanced-stage breast cancer?▼
Radiotherapy is used only when surgery is not possible. If chemotherapy shrinks the tumor enough that surgery becomes feasible, surgery should be done. Radiotherapy has very few indications in advanced disease, so a direct comparison between the two is not really meaningful in this setting.
What are the natural causes of breast cancer?▼
There is no true natural cause; the underlying event is always a gene mutation. About 80% of cases are sporadic mutations with no identifiable cause, while 10 to 15% are genetic or familial. Smoking, alcohol, and tobacco all contribute to mutation risk generally and should be avoided, though this applies to cancer as a whole rather than being specific to breast cancer.
On an evolutionary level, how does breast cancer differ between men and women?▼
There is no meaningful difference. The same hormone receptors, estrogen, progesterone, and HER2, apply in both male and female breast cancer, and treatment remains the same regardless of sex.
Is there a correlation between certain cosmetics, such as talc or lipstick, and the development of breast cancer?▼
Various myths and misconceptions exist around this, including the use of talc in the axilla. Some print media point to possible links, but there is no confirmatory or corroborative evidence for a connection between cosmetics and breast cancer.
How common is breast cancer worldwide, and in Africa specifically?▼
Breast cancer accounts for about 11.5% of all cancers diagnosed worldwide, and Africa contributes roughly 8.6% of the global breast cancer burden.
Is breast cancer treatable at every stage?▼
Yes. Treatment options exist at every stage of breast cancer, spanning surgery, chemotherapy, radiation, hormonal therapy, targeted therapy, and immunotherapy, which is why it is often described to patients as one of the more treatable cancers across its full range of stages.
In This Series: Diagnosis and Management of Breast Cancer
- 1.Diagnosis and Management of Breast Cancer
- 2.How Breast Cancer Presents: Warning Signs Every Referring Doctor Should Know
- 3.The Triple Assessment: Clinical, Radiological and Pathological Workup
- 4.Biopsy Techniques and Receptor Testing in Breast Cancer
- 5.Staging Breast Cancer and How Tumor Biology Drives Treatment Sequencing
- 6.Breast Conservation Surgery vs Mastectomy: When Each Is Appropriate
- 7.Axillary Management: Lymph Node Dissection vs Sentinel Node Biopsy
- 8.Radiation Therapy After Breast Cancer Surgery: When It's Needed
- 9.Chemotherapy, Hormonal and Targeted Therapy: Regimens and Managing Metastatic Disease