Breast cancer

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Breast cancer

• Prof.Nazem shams

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IS IT A SERIOUS PROBLEM ??
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Breast findings
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Anatomy
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Types of breast cancer

• In situ
• Intraductal (DCIS)
• Intralobular (LCIS)
• Invasive
• Infiltrating ductal carcinoma
• Tubular carcinoma
• Medullary carcinoma
• Mucinous carcinoma

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Presentation
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CANCER BREAST

• Skin manifestations
• 1) Skin dimpling, Tethering Puckering-
• 2) Skin fixation, ulceration fungation
• 3) Nipple retraction
• 4) Paget's disease of nipple
• 5) Peau dorange
• 6) Cancerous satellite nodules (late sign)
• 7) Cancer en cuirasse (very late sign)
• 8) Mastitis carcinomatosa
• 9) Malignant edema of upper limb (brawny arm)
• 10) Dilated veins

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CYSTSARCOMA PHYLLOIDE TUMORS
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dimpling
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Nipple retraction
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Paget disease
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Paget disease
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Eczema
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Peau dorange
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ulceration fungation
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Mastitis carcinomatosa
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satellite nodules
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Cancer en cuirasse
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edema of upper limb
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Winging of the scapula
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Risk factors of breast cancer
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Breast cancer pathology
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• Tx No evidence of primary tumor
• Tis Carcinoma in situ
• T1 Tumor 2cm or lt
• T2 2 to 5 cm
• T3 Tgt 5cm
• T4a extension to chest wall
• T4b edema (including peau dorange), ulceration
  of skin, satellite nodules
• T4c T4a T4b
• T4d Inflammatory carcinoma

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• N0 no regional lymh node met.
• N1 Movable ipsilateral axillary l.nod.
• N2 Fixed ipsilateral axillary lymph n. or
  Internal mammary lymh nodes
• N3 -Ipsilateral supraclavicular l.n.
• -Fixed ipsilateral axillary lymph n.
  and Internal mammary lymh nodes
• -Ipsilateral infraclavicular l.n.

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• M0
• M1

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Stage 1

• Tumor lt 2.0 cm in greatest dimension
• No nodal involvement (N0)
• No metastases (M0)

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Stage II

• Tumor gt 2.0 lt 5 cm
• or
• Ipsilateral axillary lymph node (N1)
• No Metastasis (M0)

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Stage III

• Tumor gt 5 cm (T3)
• or ipsilateral axillary lymph nodes fixed to
  each other or other structures (N2)
• involvement of ipsilateral internal mammary nodes
  (N3)
• Inflammatory carcinoma (T4d)

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Stage IV (Metastatic breast cancer)

• Any T
• Any N
• Metastasis (M1)

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INVESTIGATIONS
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