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 :