BREAST CANCER

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BREAST CANCER
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Breast Cancer

• Breast cancer occurs when abnormal cells grow out
  of control in one or both breasts. They can
  invade nearby tissues and form a mass called a
  malignant tumor. The cancer cells can spread
  (metastasize) to the lymph nodes and other parts
  of the body.

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Overview and Statistics

• Worldwide, breast cancer comprises 10.4 of all
  cancer incidences among women, making it the
  second most common type of non-skin cancer (after
  lung cancer) and the fifth most common cause of
  cancer death. In 2004, breast cancer caused
  519,000 deaths worldwide (7 of cancer deaths
  almost 1 of all deaths). Breast cancer is about
  100times more common in women than in men, but
  survival rates are equal

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• 26 females out of 100 females and 1 male for
  every 105 males may be diagnosed with breast
  cancer in the Philippines. Since the 1980s,
  breast cancer ranks 1st among the top leading
  cancers afflicting women in the Philippines and
  ranks 2nd to lung cancer if both sexes are
  considered. Its incidence starts to peak at the
  age of30 in women. (Source Philippine Cancer
  Facts Estimates, PCSI, 2005.) However, it was
  reported in 2004 that breast cancer cases in the
  Philippines exceeded lung cancer by 685 cases for
  both sexes (source UP-DOH report)

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• Recently, more women are presenting with
  bilateral disease at an early age(30s-40s).
  Generally, the disease is still being diagnosed
  late in its course hence the survival rate of
  breast cancer in the Philippines is below 50.
  Making the situation more difficult, an estimated
  seventy percent (70) of breast cancer patients
  in the Philippines are indigents.

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• Alarmingly, the Philippines has the highest
  prevalence of breast cancer in Asia.(Source
  International Agency for Research on Cancer,
  2004). In addition to the successful reduction in
  fertility and westernization of the Filipino
  lifestyle, the limited access to breast health
  contributes significantly to its recorded highest
  prevalence in Asia. Among the reasons for the
  limited access to breast health in the
  Philippines include location of health
  facilities, limited income, high prices of
  diagnostic tests and hospital care, low levels of
  education, and the lack of breast cancer
  awareness.

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Breast Cancer Risk Factors

• that cannot be changed
• Age
• Family/Personal History
• Race
• Treatment with DES
• Radiation
• Genetic Factors
• Menstrual History
• Reproductive History

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Breast Cancer Risk Factors

• that can be controlled
• Obesity
• Exercise
• Breastfeeding
• Alcohol
• HRT
• Birth control pills
• Not having children

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Signs and Symptoms
Most common lump or thickening in breast.
Often painless
Redness or pitting of skin over the breast, like
the skin of an orange
Discharge or bleeding
Change in size or contours of breast
Change in color or appearance of areola
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Staging of Breast Cancer

• T tumor size
• N lymph node involvement
• M metastasis

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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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Types of breast cancer

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

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Diagnosis Tests

• Breast Self Exam
• - The breast self-exam is a way that you can
  check your breasts for changes (such as lumps or
  thickenings). It includes looking at and feeling
  your breast. Any unusual changes should be
  reported to your doctor. When breast cancer is
  detected in its early stages, your chances for
  surviving the disease are greatly improved.

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Breast Self Examination

• Opportunity for woman
• to become familiar
• with her breasts
• Monthly exam of the
• breasts and underarm area
• May discover any
• changes early
• Begin at age 20, continue monthly

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When to do BSE

• menstruating women- 5 to 7
• days after the beginning of
• their period
• Menopausal women -same
• date each month
• Pregnant women same date each month
• Takes about 20 minutes
• Perform BSE at least once a month
• Examine all breast tissue

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Diagnosis Tests

• Clinical Breast Exam
• A breast exam by a Health professional (such as
  your doctor, nurse, nurse practitioner, Or
  physician assistant) is an important part of
  routine physical checkups. You should have a
  clinical breast exam at least every three years
  starting at age 20 and every year starting at age
  40. A clinical breast exam may be recommended
  more frequently if you have a strong family
• history of breast cancer.

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Why dont more women practice BSE?

• Fear
• Embarrassment
• Youth
• Lack of knowledge
• Too busy, forgetfulness

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Diagnosis Tests

• Mammogram
• Mammograms are a good way of identifying
  abnormalities in the breast
• Used for women over the age of 35
• - In younger women the breast tissue is more
  dense, which makes it difficult to detect any
  changes on the mammogram.

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Mammography Equipment
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Diagnosis Tests

• Breast Ultrasound
• - Breast ultrasound is a procedure that may be
  used to determine whether a lump is a cyst (sac
  containing fluid)or a solid mass which could be
  cancer. If it is found to be a cyst, fluid is
  typically withdrawn from it using a needle and
  syringe (a process called aspiration). If clear
  fluid is removed and the mass completely
  disappears, no further treatment or evaluation is
  needed.

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Diagnosis Tests

• OPEN BIOPSY
• A biopsy is the only way to tell for sure if
  cancer is present.
• an incisional biopsy takes a sample of a lump or
  abnormal area.
• An excisional biopsy takes the entire lump or
  area.
• This procedure is done either under local
  anaesthesia or general anaesthesia

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OTHER INVESTIGATIONS

• ?CHEST X RAY
• ?ABDOMINAL ULTRASOUND
• Needle tests (FNAC)
• ?CT OF THE BRAIN
• ?BONE SCINTIGRAPHY

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Breast Cancer Treatments

• Surgery
• Radiation Therapy
• Chemotheraphy
• Hormone Theraphy
• Immunotherapy

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LOCAL TREATMENT

• Surgery Lumpectomy A surgical procedure to
  remove a tumor (lump) and a small amount of
  normal tissue around it.
• Partial mastectomy A surgical procedure to
  remove the part of the breast that contains
  cancer and some normal tissue around it. This
  procedure is also called a segmental mastectomy.

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LOCAL TREATMENT

• Total mastectomy A surgical procedure to
• remove the whole breast that contains cancer.
  This procedure is also called simplemastectomy.
• Modified radical mastectomy A surgical procedure
  to remove the whole breast that contains cancer,
  many of the lymph nodes under the arm, the lining
  over the chest muscles, and sometimes, part of
  the chest wall muscles.

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LOCAL TREATMENT

• Radical mastectomy A surgical procedure to
  remove the breast that contains cancer, chest
  wall muscles under the breast, and all of the
  lymph nodes under the arm. This procedure is
  sometimes called a Halsted radical mastectomy.
• Radiation therapy uses high energy rays (similar
  to x-rays) to kill cancer cells. It comes from an
  external source, and it requires patients to come
  in 5 days a week for up to 6 weeks to a radiation
  therapy treatment center

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SYSTEMATIC TREATMENT

• Chemotherapy is the use of anti-cancer drugs that
  go throughout the entire body.
• Hormonal Therapy When the pathologist examines
  your tumor specimen, he or she finds out if the
  tumor is expressing estrogen and progesterone
  receptors.
• Biologic Therapy The pathologist also examines
  your tumor for the presence of HER-2/neu over
  expression. HER-2/neu is a receptor that some
  breast cancers express. A compound called
  Herceptin (or Trastuzumab) is a substance that
  blocks this receptor and helps stop the breast
  cancer from growing.

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PREVENTION

• 1.Pass on that last call for alcohol.
• 2. Quitters DO prosper - when it comes to
• smoking.
• 3. Get physical/Regular aerobic exercise
• 4. Be aware of your family breast cancer history.
• 5. Avoid hormone replacement therapy if possible

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PREVENTION

• 6. Check your breasts every month.
• 7. Try to keep a low fat diet/Your diet can play
  an important role in breast cancerprevention.
• 8. Don't forget to get a mammogram
• 9. Have children earlier in life, if possible
• 10. Consider breastfeeding instead of
  formulafeeding.

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PHOTOS OF BREAST CA
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PHOTOS OF BREAST CA
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PHOTOS OF BREAST CA
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PHOTOS OF BREAST CA
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