Breast Carcinoma

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Breast Carcinoma
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Anatomy
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Epidemiology 10 17.1/10 28/10 46/10 1.2
m world wide 6 develop cancer of the breast
in their lifetime. 50,000 to 70,000 new cases
USA
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Risk Factors for Breast Cancer Major

Minor Gender(femalegtmale)
Early menarche Age
Late minopause Family
history(mother,sister,or Obesity
daughter with premenopausal Low-dose
radiation or bilateral cancer) Personal
history of contralateral BC Nonivasive carcinoma
(ductal or lobular carcinoma in situ) Benign
proliferative changes with atypia
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Pathology of Breast Cancer Noinvasive 1?Ductal
Carcinoma in situ (DCIS),intraductal 2?Lobular
Carcinoma in situ (LCIS) Invasive 1?Infiltrating
ductal carcinoma this is the most common
malignant tumor in the breast recognized
after biopsy. 2?Invasive Lobular
carcinoma Pagets disease of the nipple
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• Diagnosis of Breast Mass
• history and physical examination
• Risk factors for breast cancer
• 3 fine-needle aspiration
• 4 breast imaging
• 5 ultrasonography, thermography, computed
  tomography (CT), magnetic resonance imaging
  (MRI), mammography.

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Staging Breast Cancer T1 tumor more
than 2 cm or less in greatest dimension
T2 tumor more than 2 cm, but not more then 5 cm
in greatest dimension
T3 tumor more than 5 cm in greatest dimension
T4 tumor in any size with direct
extension to chest wall or skin No no
regional lymph node metastasis N1
metastasis to movable ipsilateral axillary lymph
node N2 metastasis to ipsilateral
axillary lymph nodes that are
fixed to one another or to other structures
N3 metastasis to ipsilateral internal
mammaryl lymph node Mo no distant
metastasis M1 distant metastasis
(includes metastasis to ipsilateral
supraclavicular lymph node)
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• Surgical Procedures Past and Present
• In 1894, Halsted
• Radical and Extended Radical mastectomy
• Modified radial mastectomy
• Patey
• Auchincloss

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Adjuvant chemotherapy for operable breast
cancer 1)  Adjuvant chemotherapy for lymph
node-positive patients 2) Adjuvant
chemotherapy for lymph node-negative
patients Hormonal therapy for breast cancer
1) Steroid hormone receptors 2) Adjuvant
hormonal therapy for operable breast cancer
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Recommendations for Adjuvant Treatment Menopausal
Axilliary Tumor
Recommended Treatment Starus
Nodes Characteristics Premenopausal
Positive Favorable or Un
Combination chemotherapy Premenopausal
Negative Favorable No data
to support adjuvant Premenopausal Negative
Unfavorable Combination
Chemotherapy Postmenopausal Positive
Favorable TamoxifenChemotherapy P
ostmenopausal Positive Unfavorable
Chemotherapy Tamoxifen Postmenopausal
Negative Favorable No data
to support adjuvant Postmenopausal Negative
Unfavorable No data to support
adjuvant Favorable tumor characteristic include
sizelt2 cm, Er or PgR positive,nuclear and
histologic grade good(1 or 2)
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Thank you