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Presentation on theme: "BREAST CANCER."— Presentation transcript:


2 Anatomy of the Breast The Breast – Mammary gland Glandular tissue
Duct system Fat

3 Anatomy of the Breast The nipple – smooth muscle fibers
The areola – contains sebaceous glands Lactiferous ducts Lactiferous sinus Cooper’s ligaments

4 Anatomy of the Breast Arterial supply
Artery thoracic internal , axillary artery, intercostal arteries Venous drainage Axillary vein Lymphatic drainage Axillary nodes

5 Fibrocystic Disease Fibrosis Cystic disease Sclerosing adenosis
Epithelial hyperplasia

6 Fibrocystic Disease Fibrocystic disease Cancer
Often bilateral Unilateral Multiple nodules Single Menstrual variation No variation Cystic pain No pain May regress Does not regress

7 Breast Tumors Fibroademona Cystosarcoma phyllodes
Intraductal papilloma Carcinoma of the breast

8 Breast Cancer Statistics
Lung – 25% Breast – 11% Colon and Rectum-11%

9 Breast Cancer Statistics
In the USA: 211,000 new cases of invasive breast cancer will be diagnosed this year 43,300 patients will die

10 Risk Factors of Breast Cancer
1) Fibrocystic disease 2) Menarche disorders 3) Diets high in saturated fat 4) Family history of breast cancer 5) Late or no pregnancies 6) Moderate alcohol intake 7) Estrogen replacement therapy

11 Pathogenesis of Breast Cancer
Genetic (BRCA 1 on 17q and BRCA 2 on 13q) Viral Environmental Hormonal role (“unopposed estrogen”)

12 Breast Cancer Classification
Noninfiltrating intraductal carcinoma Infiltrating ductal carcinoma Medullary carcinoma Colloid (mucinous) carcinoma Lobular carcinoma Paget’s disease of the breast Inflammatory carcinoma

13 Non-infiltrative intraductal carcinoma
“Comedocarcinoma” Microscopically: Typical duct epithelial cells proliferate Ductal dilatation

14 Infiltrative ductal carcinoma
Rock-hard palpable tumors 2-5 cm in diameter Nipple retraction Necrosis and calcification Microscopically: Anaplastic duct epithelial cells Fibrous reaction

15 Medullary carcinoma Fleshy masses 5-10 cm in diameter
Little fibrous tissue Microscopically Large pleomorphic cells Lymphocytic infiltrate

16 Colloid (mucinous) carcinoma
Soft, large, gelatinous tumor Microscopically Tumor cells and mucin

17 Lobular carcinoma Arises from terminal ductules Multicentric tumors
Rubbery and ill-defined tumors Microscopically Small cells arranged in rings Small cells are confined to lobules

18 Paget’s disease The skin of the nipple and areola are ulcerated
Inflammation Bacterial infection Microscopically Ductal carcinoma “Paget’s cells”

19 Inflammatory Breast Cancer

20 Breast Cancer TNM-classisfication
TIS = Paget's Disease without a tumor, Carcinoma in-situ T1 = Tumor less than 2 cm. in greatest dimension T2 = Tumor larger than 2 cm. in size but less than 5cm. T3 = Tumor larger than 5 cm. in size T4 = Tumor of any size extending to the chest wall or skin N1 = Metastasis to moveable axillary nodes N2 = Metastasis to fixed or matted axillary nodes N3 = Metastasis to supraclavicular, infraclavicular or internal mammary nodes M0 = no distant metastasis M1 = distant metastasis

21 Stages of Breast Cancer
Stage I T1 N0 M0 Stage II T0 N1 M0 T1 N1 M0 T2 N0 N1 M0 Stage IIIA T0 N2 M0 T1 N2 M0 T2 N2 M0 T3 N0, N1, N2 M0 Stage IIIB Any T N3 M0 T4 Any N M0 Stage IV Any T Any N M1

22 Breast Cancer Classification
5-year survival rate Stage I % Stage II % Stage IIIa % Stage IIIb % Stage IV %

23 Breast Cancer Treatment Segmental mastectomy Simple mastectomy
Modified radical mastectomy Radical mastectomy

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