Ask a Librarian: Breast cancer

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Breast cancer is the most common cancer — and the second leading cause of cancer death among Canadian women. However, with recent advances and ongoing research in diagnosis and treatment, almost 9 in 10 women with breast cancer will now survive at least 5 years past their diagnosis.

Here are some resources on breast cancer selected by Joule’s Ask a Librarian team using a variety of tools — some are included with CMA membership, others are freely available online.

 

Clinical summary from DynaMed

Access DynaMed online or through the mobile app to get concise overviews and detailed recommendations, medical graphics and images, drug information from Micromedex and more.

Breast Cancer in Women

Overview and Recommendations

Background

  • Breast cancer is a malignancy of the breast tissue and is the most common malignancy diagnosed in women worldwide.
  • Early or operable breast cancer is considered potentially curable and includes stage I-IIB and some stage IIIA cancers, specifically T3, N1 tumors.
  • Noninflammatory locally advanced inoperable breast cancer is considered potentially curable and includes stage IIIA-C breast tumors with the exception of some stage IIIA, specifically T3, N1 tumors.
  • Inflammatory breast cancer is a rare, aggressive subtype of locally advanced breast cancer characterized by a substantial area of breast skin that is red in color, warm, and thickened or swollen (referred to as peau d'orange).
  • Advanced (metastatic) breast cancer encompasses disease that has spread beyond the breast and regional lymph nodes and is either de novo stage IV (metastatic at the time of initial diagnosis) or a metastatic recurrence. Common sites of metastases include bone, liver, lung, and brain.
  • Risk factors for breast cancer include genetic causes, increased age, reproductive history and hormone exposure, lifestyle factors, medical history, and radiation exposure.
  • Women with breast cancer may present with breast abnormalities detected during screening, without any other signs or symptoms. Common signs and symptoms of breast cancer include palpable breast mass, axillary mass, nipple discharge, skin changes on breast or nipple, asymmetric thickening or nodularity, breast pain, or signs and/or symptoms due to metastatic disease.
  • The 5-year survival after diagnosis of breast cancer is 99% for women with localized disease, 85% for women with regional spread, and 27% for women with distant metastases in the United States; in addition, women with estrogen receptor positive cancers treated with endocrine therapy have a 13%-41% risk of recurrence 5-20 years after diagnosis. Factors affecting prognosis include tumor and disease characteristics, age, response to therapy, race and ethnicity, and body mass.

See related DynaMed summaries (selected):

Breast Cancer in Women topic summary (CMA members can access full summaries for this and other topics via this link)

 

Clinical information via ClinicalKey:

ClinicalKey drives better care by delivering fast, concise answers, and deep access to evidence whenever, wherever you need it. ClinicalKey includes access to 1,000+ textbooks, 600 full-text journals, images, videos and customizable patient handouts across 30+ medical specialties

Clinical Overviews

Breast cancer in females. Updated September 11, 2020

Breast cancer in males. Updated September 15, 2020

Breast Cancer in Ferri's Clinical Advisor 2021

Book chapters

Tumors of the Breast in Diagnostic Histopathology of Tumors, 2021. Chapter 16, 1119-1210

A Surgeon’s Practical Guide to Breast Imaging in Current Surgical Therapy, 2020. 712-718

Carcinoma of the Breast in Robbins & Cotran Pathologic Basis of Disease, 2021, Chapter 23, 1037-1064

Cancer of the Breast in Abeloff's Clinical Oncology, 2020, Chapter 88, 1560-1603.e12

Locally Advanced and Inflammatory Breast Cancer in Gunderson & Tepper’s Clinical Radiation Oncology, Chapter 74, 1342-1358.e2

 

Free information sources

CMAJ

Henry Li, Laurence Stillwater, Mark Bryanton and Christina A. Kim. Cases: Osseous sarcoidosis mimicking metastatic breast cancer. CMAJ July 13, 2020 192 (28) E799-E802

Ellen Warner, Karen Glass, Shu Foong and Emily Sandwith. Update on fertility preservation for younger women with breast cancer. CMAJ August 31, 2020 192 (35) E1003-E1009.

Laura Eggertson. Breast density disclosure may do more harm than good. CMAJ January 13, 2020 192 (2) E48-E49.

Emilia Nielsen. The problem of standardized breast cancer narratives. CMAJ November 25, 2019 191 (47) E1311-E1312.

Lauren Vogel. Hormone therapy study restokes debate over breast cancer risk. CMAJ September 30, 2019 191 (39) E1088-E1089.

 

Guidelines and other information

Recommendations on screening for breast cancer in women aged 40–74 years who are not at increased risk for breast cancer - Scott Klarenbach, Nicki Sims-Jones, Gabriela Lewin, Harminder Singh, Guylène Thériault, Marcello Tonelli, Marion Doull, Susan Courage, Alejandra Jaramillo Garcia and Brett D. Thombs; for the Canadian Task Force on Preventive Health Care. CMAJ December 10, 2018 190 (49) E1441-E1451 – Accessed October 9, 2020.

Choosing Wisely Canada recommendation - Don’t routinely do screening mammography for average risk women aged 40 – 49. Individual assessment of each woman’s preferences and risk should guide the discussion and decision regarding mammography screening in this age group - College of Family Physicians of Canada. Published 2019-07. Accessed October 13, 2020.

Role of patient and disease factors in adjuvant systemic therapy decision making for early-stage, operable breast cancer: update of the ASCO endorsement of the Cancer Care Ontario guideline - Cancer Care Ontario's Program in Evidence-based Care. Published 2019-08. Accessed October 13, 2020

National consensus recommendations on patient-centered care for ductal carcinoma in situ - Expert Panel on Patient-centered Care for Ductal Carcinoma in situ. Published 2019-01. Accessed October 13, 2020.

 Access more Breast cancer clinical practice guidelines via the CPG Infobase.

 

Prepopulated literature searches

PubMed Clinical Queries:

 

Patient education resources

Breast Cancer – Public Health Agency of Canada. Modified 2019-12-09. Accessed October 13, 2020

Canadian Breast Cancer Network. Accessed October 13, 2020.

Breast Cancer – Canadian Cancer Society. Accessed October 13, 2020.

Breast Cancer – Medline Plus, US National Library of Medicine. Updated September 28, 2020. Accessed October 13, 2020.

 

Need more information or have a clinical question on any other topic of interest? Contact the Ask a Librarian team to request a literature search.

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This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule. 

About the author(s)

Joule’s medical librarians are the professionals behind “Ask a Librarian”, a service for all CMA members looking for clinical search expertise. This experienced team of librarians can support you by searching on your behalf, teaching you effective search strategies or training you to use our clinical resources.

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