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BREAST CARCINOMA

BREAST CARCINOMA. ANATOMY. - Modified sweat glands. - Lobes and lobules of gland in fat tissue stroma. - Ducts emerge from acini of glands - Smaller ducts join to form lactiferous ducts.

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BREAST CARCINOMA

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  1. BREAST CARCINOMA

  2. ANATOMY - Modified sweat glands. - Lobes and lobules of gland in fat tissue stroma. - Ducts emerge from acini of glands - Smaller ducts join to form lactiferous ducts. - Lactiferous ducts merge just beneath the nipple to form a lactiferous sinus. - Then individually open on nipple

  3. BREAST CARCINOMA • The most common form of cancer among women. • The second most common cause of cancer related mortality. - 1 of 8 women (12.2%). • One third of women with breast cancer die from breast cancer.

  4. AETIOLOGICAL FACTORS - Female (1% male) - Aging - Family history (mother or sister) - Menstrual history - early onset - late menopause - Child birth - After the age of 30

  5. - Hormonal replacement therapy(HRT). - 30% increased risk with long term use - Oral Contraceptives(OC) - risk slight - risk returns to normal once the use of OC’s has been discontinued

  6. - Radiation exposure - Breast disease - Atpyical Hyperplasia - Intraductal carcinoma in situ. - Intralobular carcinoma in situ.

  7. - Obesity - Diet -Fat - Alcohol

  8. ETIOLOGY

  9. GENETICS - BRCA-1 - BRCA-2 - P53, Rb-1 - Her-2/neu, c-erB2, c-myc

  10. TYPES OF BREAST CANCER - In situ - Intraductal (DCIS) - Intralobular (LCIS) - Invasive - Infiltrating ductal carcinoma - infiltrating lobular carcinoma - Medullary carcinoma - Mucinous carcinoma

  11. CLINICAL FEATURES - Most commonly present as a hard lump - Dimpling - Nipple discharge - Thickening of skin - Retracted nipple - Ulceration - Fixation to chest wall - Regional lymph nodes enlargement - General malaise and weight loss

  12. General signs • Skeleton > pathological fractures • Lungs > pulmonary consolidation, effusion • Brain > motor, sensory and psychological defects. • Liver > hepatomegaly, jaundice, ascities

  13. STAGING OF BREAST CANCER The American Joint Committee on Cancer (AJCC) has designated staging by TNM -T= tumor size -N = lymph node involvement -M = metastasis

  14. STAGE 1 - Tumor < 2.0 cm in greatest dimension - No nodal involvement (N0) - No metastases (M0)

  15. STAGE 2 - Tumor > 2.0 < 5 cm or - Ipsilateral axillary lymph node (N1) - No Metastasis (M0)

  16. STAGE 3 - Tumor > 5 cm (T3) • or ipsilateral axillary lymph nodes fixed to each other or other structures (N2) • involvement of ipsilateral internal mammary nodes (N3)

  17. STAGE 4 METASTATIC BREAST CANCER - Any T - Any N - Metastasis (M1)

  18. SPREAD OF BREAST CANCER -LOCAL SPREAD - LYMPHATIC - Axillary and internal mammary nodes - BLOODSTREAM - Skeleton - Liver - Lungs - Brain

  19. DIAGNOSIS - CLINICAL EXAMIATION - MAMMOGRAPHY - FINE NEEDLE ASPIRATION CYTOLOGY - ULTRASOUND - IMMUNOPEROXIDASE - MOLECULAR TECHNIQUES – Gene Detection

  20. MAMMOGRAM Normal breast Breast cancer

  21. MANAGMENT - SURGERY - Radical mastectomy - Patey mastectomy - RIADIOTHERAPY - ADJUVANT SYSTEMIC THERAPY - Hormone therapy - Chemotherapy

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