Dawaa Reference

chronic

Breast cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 sources

Breast Cancer - StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK482286/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class GD27 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Menon G, Alkabban FM, Ferguson T. Breast Cancer. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Breast cancer - disease-level clinical article (breast-cancer-full.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • Pain and a rapidly enlarging breast lump, often with itching and skin swelling [breast lump · itching]
  • Swollen lymph nodes or localized pain can be the presenting complaint, depending on disease extent [breast pain · lymphadenopathy]
  • Symptoms develop quickly, over weeks to months
  • Lack of improvement after antibiotics given for presumed mastitis prompts further evaluation
  • About 10% of cases are first picked up by an abnormal screening mammogram rather than symptoms

Signs — what you find (4)

  • Breast shape may look distorted or enlarged, with orange-peel skin that feels warm and thickened
  • Nipple changes can include crusting, redness, flattening, blistering, or retraction [crusting · redness]
  • A discrete lump may or may not be felt on exam [breast lump]
  • Almost all patients already have lymph node involvement by the time they present

Tests (10)

  • Diagnosis rests on the clinical picture plus a core needle biopsy showing invasive carcinoma
  • A diagnostic mammogram is done on the affected breast and a screening mammogram on the other side
  • Mammography may show a mass, a large area of calcification, or distorted tissue with skin thickening
  • Mastitis can look similar on mammogram when inflammatory cancer has no underlying mass
  • Lack of response to a short course of antibiotics, under a week, is an indication for biopsy
  • Ultrasound may show thickened skin, fluid between tissues, and disrupted normal tissue planes
  • MRI shows multiple small, merging, enhancing masses with diffuse skin thickening
  • MRI is the most accurate imaging study for locating the primary breast lesion
  • PET/CT adds information on lymph nodes and distant spread during initial staging
  • All tumors are tested for hormone receptors and HER2 status, as with other invasive breast cancers

If not this — what else fits (4)

  • Ductal ectasia is a benign, self-resolving condition in middle-aged women from duct debris and swelling
  • Infectious mastitis in a nursing mother causes fever and a raised white count, usually resolving with antibiotics
  • Locally advanced noninflammatory cancer with skin dimpling, nipple retraction, or nodules can be hard to distinguish from the inflammatory form
  • Breast lymphoma or leukemia can mimic the presentation and needs biopsy to differentiate

SourceStatPearls "Inflammatory Breast Cancer" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

The most common cancer among Egyptian women. Definitive treatment (surgery, chemotherapy, radiotherapy, endocrine therapy) is oncology-led and not something a GP prescribes, but the GP plays a real role in early recognition of a lump or suspicious finding, prompt urgent referral, and advising on screening (clinical breast exam, mammography). - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

The most common cancer among Egyptian women. Definitive treatment (surgery, chemotherapy, radiotherapy, endocrine therapy) is oncology-led and not something a GP prescribes, but the GP plays a real role in early recognition of a lump or suspicious finding, prompt urgent referral, and advising on screening (clinical breast exam, mammography).

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Rapidly progressive inflammatory skin changes (erythema, edema, peau d'orange) that fail to improve after a short course of antibiotics (less than a week) require urgent biopsy for underlying malignancy.
  • RED FLAG - Nipple changes including crusting, erythema, flattening, blisters, or retraction indicate potential breast malignancy.
  • RED FLAG - A new breast lump, especially one that is hard, fixed or irregular; nipple retraction or discharge, particularly bloody; skin dimpling or orange-peel change; or enlarged lymph nodes in the armpit: refer urgently.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.