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BREAST CANCER
PROF.N
AZEM SHAMS
IS IT A SERIOUS PROBLEM ??
TYPES OF BREAST CANCER
In situ Intraductal (DCIS) Intralobular (LCIS)
Invasive Infiltrating ductal carcinoma Tubular carcinoma Medullary carcinoma Mucinous carcinoma
PRESENTATION :
CANCER BREASTCANCER BREAST
Skin manifestations:Skin manifestations:1) Skin dimpling, Tethering & Puckering:- 2) Skin fixation, ulceration & fungation 3) Nipple retraction: 4) Paget's disease of nipple 5) Peau d’orange:6) Cancerous satellite nodules (late sign)7) Cancer en cuirasse (very late sign)8) Mastitis carcinomatosa9) Malignant edema of upper limb (brawny
arm)10) Dilated veins
CYSTSARCOMA PHYLLOIDE TUMORS CYSTSARCOMA PHYLLOIDE TUMORS
dimplingdimpling
Nipple retractionNipple retraction
Paget disease Paget disease
Paget diseasePaget disease
EczemaEczema
Peau d’orangePeau d’orange
ulceration & fungationulceration & fungation
Mastitis carcinomatosaMastitis carcinomatosa
satellite nodulessatellite nodules
Cancer en cuirasseCancer en cuirasse
edema of upper limbedema of upper limb
Winging of the scapula Winging of the scapula
RISK FACTORS OF BREAST CANCER
BREAST CANCER PATHOLOGY
Tx No evidence of primary tumor Tis Carcinoma in situT1 Tumor 2cm or <T2 2 to 5 cmT3 T> 5cmT4a extension to chest wallT4b edema (including peau
d’orange), ulceration of skin, satellite nodules
T4c T4a + T4bT4d Inflammatory carcinoma
N0 no regional lymh node met.
N1 Movable ipsilateral axillary l.nod.
N2 Fixed ipsilateral axillary lymph n. or İnternal mammary lymh nodes
N3 -İpsilateral supraclavicular l.n.
-Fixed ipsilateral axillary lymph n. and İnternal mammary lymh nodes
-İpsilateral infraclavicular l.n.
M0
M1
STAGE 1
Tumor < 2.0 cm in greatest dimension
No nodal involvement (N0)
No metastases (M0)
STAGE II
Tumor > 2.0 < 5 cm
or
Ipsilateral axillary lymph node (N1)
No Metastasis (M0)
STAGE III
Tumor > 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)
STAGE IV (METASTATIC BREAST CANCER)
Any T
Any N
Metastasis (M1)
INVESTIGATIONS :
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