SEMINAR ON BREAST

CANCER AWARNESS PRESENTED BY

DR.RAMESH SAHARIA.

SRIDHAR CANCER CARE CENTRE SRIMANTA SANKERDEV HOSPITAL

INCIDENCE AND PREVELANCE OF BREAST CANCER.

Most common cancer in western & 2nd commonest cancer in India,after cervical cancer.

In metropolitan cities, it becomes commonest. Incidence in India is 28/lac woman. Incidence in West is 111/lac woman.

RISK FACTORS Female. M:F 1:100 Age at menarche. (<12yrs 2 fold+) Age at menopause.(>55yrs 20%risk compare with <45 yrs) Age at first live birth .(>30 yrs 2-5 fold+) Breast feeding.(risk reduction per year of breast feeding is

4.3%) Nulliparity. Races/Ethnicity. Family history/Number of 1st degree relatives with breast

cancer.(1.5-3 fold, 5 times if B/L disease) Current age.

continue:-

Number of previous benign breast biopsies.Atypical hyperplasia.(4-5 fold)Known or suspectedBRCA-1/2,p53(56-85% life-

time risk of breast cancer)Prior h/o chest radiation.H/o current or prior HRT(25-35% excess risk)Body mass index.Breast density.Alcohol consumption.(10-41%risk)smoking

SYMPTOMS Breast lump/mass Chest /axilla lump. Nipple discharge-blood,serous, pus, greenish. Asymmetrical thickening/nodularity. Nipple retraction or excoriation Skin changes:-peaud’orange,ulcer,erythema, eczema. Mets. Disease:-headache,breathing bone

pain/fracture,abdominal lump ascites.

DIAGNOSIS

Clinical examination. Mammography. USG of breast & axilla. FNAC. Biopsy. MRI breast For mets:- CT brain, chest,abdoman. Bone scan. PET Scan.

..

BREAST SCREENING AND PREVENTION

Asymptomatic and –ve physical examination. NORMAL RISK. Age >/=20 but <40yrs• Clinical breast exam every 1-3yrs.• Periodic BSE. Age >/=40 yrs.• Annual clinical breast exam.• Annual mammography.• Periodic BSE.

Continue:- INCREASED RISK. Prior thoracic RT Age <25yrs• Annual CBE.• Periodic BSE. Age >/=25yrs• Annual mammography + CBE 6-12 months.• Periodic BSE. LCIS/Atypical hyperplasia.• Annual mammography + CBE 6-12 months.• Periodic BSE• Consider risk reduction strategies.

Continue:- Strong family history or genetic predisposition. Age<25 yrs• Annual CBE.• Periodic BSE. Age >25 yrs• Annual mammography+CBE 6-12 months.5-10 yrs prior to youngest breast cancer cases.• Periodic BSE. • Annual MRI.• Consider risk reduction strategies.

Continue:-

Prior history of breast cancer • CBE every 3 months for 1st yrs, every 6 months

for next 2 yrs,then annually.• Annual mammography.• Monthly BSE.• Annual pap smear & pelvic exam. In woman

on tamoxifen .• Bone scan, PET Scan.

BREAST SELF EXAMINATION

RISK REDUCTION STRATEGIESBRCA1/2,p53, PTEN gene mutation, strong family

h/o breast & ovarian cancer, LCIS, thoracic radiation.

• Bilateral breast removal +/-reconstruction.(90%decrease risk).

• Bilateral ovary removal.(45-60%decrease risk.)• Risk reduction agents such as

tamoxifen,raloxifene,anastrozole, letrozole.(35-40%)

CONCLUSION:- Earlier we diagnosed breast CANCER better the

prognosis & survival. Delayed is due to lack of awareness, social

embarrassment ,fear of procedure,or fear of cancer; woman may be reluctant to undergo screening.

Need of an hour to motivate woman to seek prevention services.

Awareness camp/seminar should be held. Programs for new screening and treatment

approaches.

THANK YOU

INCIDENCE AND PREVELANCE OF CERVICAL CANCER.

• Leading causes of cancer death world-wide.• 5 lacs new cases per year.• 3 lacs woman die anually.• Ranks no. one in India.• 1.3 lacs new cases anually in India.• 80-90%of cases occur among woman age 35 or elder,

RISK FACTORS:-

• Human papilloma virus infection.(about 80% woman have,<5% develop cervical cancer, but all woman with cervical cancer had HPV).

• Smoking.• Early age at first birth.• Use of hormonal contraceptives• Multi-parity.• Impaired immune system(HIV infection).• Multiple partners.

SYMPTOMS:-

• Intermentrual bleeding.• Postmenopausal bleeding .• Postcoital bleeding.• Foul smelling discharge.• Pelvic/back pain.• Hematuria /rectal bleeding due to involvment of

bladder /rectum.

DIAGNOSIS:-

• PAP Smear• Colposcopy / visual inspection.• Biopsy .• USG/CTSCAN Abdomen.• Chest x-ray.

SCREENING AND PREVENTION OF CERVICAL CANCER. Woman 30yrs or more.• PAP smear every1-3 yrs,if –ve ,can be done as &

when required.• Visual inspection of cervix/Colposcopy (iodine/acetic

acid stain,if abnormal, cryosurgery/biopsy.)• HPV detection. Vaccination against HPV in adolscence & young girls. Once in lifetime screening between 35-40yrs,reduces

risk by 25-35%.Further screening at 5yrs intervals can reduces cancer risk.