Management of breast cancer

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Management of breast cancer
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Epidiomology

• BC is a major public health problem for women
  through out the world .
• BC remain the most frequent cancer in women and
  the second most frequent cause of death .
• In 2007new cases 176,296 in USA
• Death 40,515
• In Europe 429,900 new cases
• Death rate from breast cancer as decrease in USA
  and Europe by 24 this is because
• 1 .Screening mammography
• 2 .Availability of adjuvant chemotherapy
• 3 .Tamoxifin

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Risk factors

• 1.Hormonal factor
• A. Endogenous estrogen
• 1.early menarche
• 2 .late menopause
• 3 null parity
• 4.first pregnancy after age of 30 yrs
• B. Exogenous estrogen
• 1.contraceptive pills
• 2.replacement therapy

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a. high fat diet B. alcohol C. decrease vitamin
C, folate D. fruit and vegetable E. obesity 3.
familial factors 4. environmental factors A.
exposure to ionizing radiation B. those undergo
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• 2. dietary and life style factors
• A. high fat diet
• B. alcohol
• C. decrease vitamin C , folate
• D. fruit and vegetable
• E. obesity
• 3. familial factors
• 4.enviromental factors
• A. exposure to ionizing radiation

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• B. those undergone multiple diagnostic x-ray
  examination
• C. women receiving therapeutic irradiation
• D. exposure to chemical substance (organochlore
  pesticide)

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Diagnosis

• 1.history and physical examination
• 2. mammographic study
• 3.ultrasound of breast
• 4. MRI of breast
• 5. FNA and excisional biopsy
• 6. tumor marker study
• A. CA 15 _3
• B.ER,PR,HER2,P53,CA27_29

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Treatment

• 1. surgical
• mastactomy axillary clearance
• 2. adjuvant therapy
• A. chemotherapy
• B. radiotherapy
• C. hormonal therapy