First month Second Month First month Second Month Milk line remnant Milk line remnant Accessory axillary breast tissue Accessory axillary breast tissue.

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Presentation transcript:

First month Second Month First month Second Month Milk line remnant Milk line remnant Accessory axillary breast tissue Accessory axillary breast tissue Congenital nipple inversion Congenital nipple inversion

Life long breast changes

Cyclic hormonal effect

Breast abscess Breast abscess

Granulomatous mastitis

Periductal (recurrent )mastitis

Mammary ductectasia

Fat necrosis

Prolactinoma

Fibroademoma Fibroademoma

Phyllodes Tumor

Sarcoma Radiation induced angiosarcoma

Fibrocystic changes

Cribriform and solid in situ carcinoma

Comedo carcinoma

Paget’s disease

Infiltrating ductal carcinoma

Invasive ductal carcinoma

Grading Modified Bloom Richardson Grading System Modified Bloom Richardson Grading System

ER PR HER2 P53

Metastasis

Breast Carcinoma Metastasis

Risk Factors Age Age Genetics: BRCA1,BRCA2(first degree relatives) Genetics: BRCA1,BRCA2(first degree relatives) Carcinoma of contralateral breast Carcinoma of contralateral breast Endometrial carcinoma Endometrial carcinoma Reproductive life( early menarche, late menopause) Reproductive life( early menarche, late menopause) Parity( nulliparous > multiparous) Parity( nulliparous > multiparous) First live birth First live birth Race (Northern Europe) Race (Northern Europe) Geographic Influence (immigration) Geographic Influence (immigration) Radiation Exposure (therapeutic or environmental) Radiation Exposure (therapeutic or environmental)

Risk Factors Cont’ed Estrogen exposure Estrogen exposure Obesity( specially in postmenopausal state) Obesity( specially in postmenopausal state) Diet Diet Exercise Exercise Breast feeding Breast feeding Environmental toxins Environmental toxins Tobacco Tobacco

Prognostic and predictive factors Major: Invasive vs In situ Invasive vs In situ Distant Metastasis Distant Metastasis Lymph node metastasis Lymph node metastasis Locally advanced disease Locally advanced disease Inflammatory carcinoma Inflammatory carcinoma

Prognostic Factors cont’ed Minor: Histological type Histological type Tumor grade Tumor grade Estrogen and progesterone receptors Estrogen and progesterone receptors Lymphovascular invasion Lymphovascular invasion Proliferative rate Proliferative rate DNA content DNA content

Staging Stage 0: DCIS or LCIS ( 5 year survival 92%) Stage I : Invasive <2 cm, including in situ and microinvasive microinvasive Stage II: Invasive 5cm without nodal involvement involvement Stage III: Invasive>5 cm+ nodal involvement or any breast ca+ fixed L.N, or any breast ca+ fixed L.N, or inflammatory breast cancer inflammatory breast cancer Stage IV: Any form of breast Ca+ distant breast metastasis metastasis

Treatment option based on LN involvement 0: No systemic therapy depends on the main tumor tumor 1-3: some form of standard systemic treatment indicated ( hormonal or chemotherapy) indicated ( hormonal or chemotherapy) 4-9: high dose chemotherapy 10 or more: autologous bone marrow transplantation transplantation

Lobular Carcinoma

Colloid Carcinoma

Tubular Carcinoma

Medullary Carcinoma

Breast B. cell Lymphoma

Metastasis to the breast

Gynecomastia

Male breast Carcinoma