Dawaa Reference

Clinical reference

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.