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Breast short note by S.Wichien (SNG KKU)


St gallen

Low risk
-node -ve and all of

-T<2cm
-gr1

-no perivascular invasion

-ER,PR +ve
-HER2 -ve

->35yr



Intermediate risk
Node -ve and at least one of

-T>2cm

-gr2,3
-perivascular invasion

-ER,PR -ve
-HER2 +ve

-<35yr


Node +ve (1-3) and

-ER,PR +ve

-HER2 -ve


High risk

Node +ve (1-3) and

-ER,PR -ve
-HER2 +ve



Node +ve (>4)





E.rxn E.uncertain E.nonrxn

low ET ET -
Inter ET CT-->ET CT

or (antra) (antra/tax)

CT-->ET
(CMF/antra)

high CT-->ET CT-->ET CT
(antra) (antra) (tax)



E.responsive--ER/PR+ve

E.uncertain--ER/PR+ve but <10%

E.non-responsive--ER/PR-ve


















Van Nuy prognostic index (DCIS)

1 2 3
size <=15 16-40 >=41

margin >=10 1-9 <=1
patho

-hi gr no no yes

-necrosis no yes y/n
-nuclear gr 1,2 1,2 3

age >60 40-60 <40



4-6=excision/lumpectomy only
7-9=add XRT

10-12=mastectomy


BIRADs

Breast Imaging Reporting And Data S.
0=incomplete--additional imaging

1=neg--routine screening

2=benign--routine screening
3=probably benign-->98%

:microcalcify--f/u 6 mo

:mass--f/u 4 mo

4=suspicious abnormality--5-95%--bx
4a=low probability

4b=intermediate probability

4c=intermediate but not typical
5=highly suspicious-->=95%--bx/sx

6=known bx proven malignancy

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