Breast Pathology and Cancer Diagnosis

Controversies in Breast Cancer

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Globally, breast cancer (BC) is one of the most frequently diagnosed cancers. More than 1.6 million new cases of BC are identified among women, according to the recent worldwide available data. In addition, the cumulative incidence of BC rose by more than a quarter between 1980 and 2010 among 187 countries. This raise has been succeeded thanks to BC awareness and early detection of breast malignancy.

Taking into consideration the progress in diagnosis and treatment, it is inevitable that some controversies will come up in daily clinical practice. The aim of this review is to illustrate some of these conflicting issues and make them less “ambiguous”. Especially, in the diagnosis field, the subjects which are discussed below are mammography, breast tomosynthesis, 3D ultrasound, shear wave elastography, magnetic resonance imaging, fine needle aspiration and core biopsy, computed tomography, positron emission tomography-computed tomography (PET-CT), axillary node dissection, sentinel lymph node biopsy, internal mammary node sampling and negative margin widths. As for the controversial issues based on treatment, these are partial breast radiotherapy, breast reconstruction, a sequence of radiotherapy and chemotherapy, hormone therapy and biphosphonates. However, the follow-up of BC survivors has not been overlooked.