These diseases are discussed elsewhere in PDQ under the specific disease types. Patient evaluation Patient management following initial suspicion of breast cancer generally includes confirmation of the diagnosis, evaluation of stage of disease, and selection of therapy. Diagnosis may be made by use of established prognostic markers. At the time the tumor tissue is surgically removed, ER and PR status should be determined. Contralateral disease Pathologically, breast cancer can be a multicentric and bilateral disease.
Bilateral disease is somewhat more common in patients with infiltrating lobular carcinoma.
Therefore, patients who have breast cancer should have bilateral mammography at the time of diagnosis to rule out synchronous disease. Patients should continue to have regular breast physical examinations and mammography to detect either recurrence in the ipsilateral breast in those patients treated with breast-conserving surgery or a second primary cancer in the contralateral breast. The development of a contralateral breast cancer is associated with an increased risk of distant recurrence. HRT has generally not been used for women with a history of breast cancer because estrogen is a growth factor for most breast cancer cells in the laboratory. Neither pregnancy after breast cancer nor the use of oral contraceptive pills before a diagnosis of breast cancer has been shown to adversely impact survival when controlled for stage of disease.