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Case 7.1Breast Cancer

BY: Abdullatiff Sami AL-Rashed

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Objectives 1. What Is Breast Cancer.2. Types of Breast Cancer.3. Etiology of breast cancer.4. Risk factors.5. Signs and symptoms.6. Investigations.7. Treatment.8. Prevention.9. Screening.10. Question asked by my colleagues.

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What Is Breast Cancer Breast cancer is a malignant

tumor that starts in the cells of the breast.

A malignant tumor is a group of cancer cells that can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body.

The disease occurs almost entirely in women, but men can get it, too.

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What Is Breast Cancer Most commonly from the inner

lining of milk ducts or the lobules that supply the ducts with milk.

Cancers originating from ducts are known as ductal carcinomas, while those originating from lobules are known as lobular carcinomas.

Breast cancer showing an inverted nipple, lump and skin dimpling.Author: Hic et nunc

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Types of Breast Cancer There are many types of

breast cancer:1. Ductal carcinoma in citu

(DCIS).2. Invasive Ductal

Carcinoma.3. Inflammatory Breast

Cancer.4. Metastatic Breast Cancer.5. Some other specific types.

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Types of Breast Cancer1. Ductal carcinoma in citu

(DCIS) :is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct.

The atypical cells have not spread outside of the ducts into the surrounding breast tissue.

Ductal carcinoma In situ is very early cancer that is highly treatable, but if it’s left untreated or undetected, it can spread into the surrounding breast tissue.

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Types of Breast Cancer

2. INVASIVE DUCTAL CARCINOMA:

The abnormal cancer cells that began forming in the milk ducts have spread beyond the ducts into other parts of the breast tissue.

IDC is the most common type of breast cancer, making up nearly 70- 80% of all breast cancer diagnoses.

IDC is also the type of breast cancer that can most commonly affects men

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Types of Breast Cancer3. Inflammatory Breast Cancer:

Inflammatory Breast Cancer is an an aggressive and fast growing breast cancer in which cancer cells infiltrate the skin and lymph vessels of the breast.

It often produces no distinct tumor or lump that can be felt and isolated within the breast.

  But when the lymph vessels become blocked by the breast cancer cells, symptoms begin to appear.

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Types of Breast Cancer4. Metastatic Breast

Cancer:

The cancer has spread to other parts of the body.

This usually includes the lungs, liver, bones or brain.

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Etiology When you're told that someone have

breast cancer, it’s natural to wonder what may have caused the disease.

But no one knows the exact causes of breast cancer.

Doctors seldom know why one woman develops breast cancer and another doesn’t, and most women who have breast cancer will never be able to pinpoint an exact cause.

 What we do know is that breast cancer is always caused by damage to a cell's DNA.

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Etiology Cont.. But doctors have

known some risk factors that increase the chance to get a breast cancer.

Women with certain risk factors are more likely than others to develop breast cancer.

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Risk Factors There are some risk factors

for the breast cancer:

1. Gender.

2. Age.

3. Genetics related.

4. Family history.

5. Personal history of breast cancer.

6. Menstrual periods.

7. Having children.

8. Birth control.

9. Breastfeeding

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Risk Factors1. Gender: Being a

woman is the main risk for breast cancer. While men also get the disease, it is about 100 times more common in women than in men.

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Risk Factors2. Age: The chance

of getting breast cancer goes up as a woman gets older.

About 2 of 3 women with invasive breast cancer are 55 or older when the cancer is found.

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Risk Factors3. Genetic risk factors:

About 5% to 10% of breast cancers are thought to be linked to inherited changes (mutations) in certain genes.

3. The most common changes are those of the BRCA1 and BRCA2 genes. Women with these gene changes have up to an 80% chance of getting breast cancer during their lifetimes

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Risk Factors4. Family history: Breast

cancer risk is higher among women whose close blood relatives have this disease.

The relatives can be from either the mother’s or father’s side of the family. Having a mother, sister, or daughter with breast cancer about doubles a woman’s risk.

It’s important to note that most (over 85%) women who get breast cancer do not have a family history of this disease, so not having a relative with breast cancer doesn’t mean you won’t get it.

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Risk Factors5. Personal history

of breast cancer: A woman with cancer in one breast has a greater chance of getting a new cancer in the other breast or in another part of the same breast.

This is different from a return of the first cancer (called a recurrence).

MRI screening recommended for women with a history of breast cancer

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Risk Factors6. Menstrual periods:

Women who began having periods early (before age 12) or who went through the change of life (menopause) after the age of 55 have a slightly increased risk of breast cancer.

The increase in risk may be due to a longer lifetime exposure to the hormones estrogen and progesterone.

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Risk Factors7. Having Children:

Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk.

Having many pregnancies and becoming pregnant at a young age reduce breast cancer risk.

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Risk Factors8. Birth control:

Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them.

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Risk Factors9. Breastfeeding:

Some studies suggest that breastfeeding may slightly lower breast cancer risk, especially if breastfeeding is continued for 1½ to 2 years.

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Sings and Symptoms:

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Investigations Doctors can investigate the

breast cancer by doing:

1. Mammography: The goal of mammography is the early detection of breast cancer.

2. Breast ultrasound.

3. Magnetic resonance imaging

mammogram

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Investigations4. Breast Biopsy:

A breast biopsy is a small needle sample of tissue taken from your breast.

Several samples may be taken and sent to a laboratory for testing to find out if the lump is cancerous or not.

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Treatment The treatment of

breast cancer has certain steps:

1. Surgery.

2. Chemotherapy.

3. Radiotherapy

4. Hormonal therapy

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Treatment Cont..1. Surgery:

The first step and most common form of treatment for breast cancer is surgery.

Surgery involves removing the tumor and nearby margins.

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Treatment Cont.. There are certain

procedures in surgery:

1. Lumpectomy: removal of cancerous tumor without removing the entire breast.

2. mastectomy: removal of the entire breast.

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lumpectomy

Total mastectomy

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Treatment Cont..2. Chemotherapy : is a

breast cancer treatment method that uses a combination of drugs to either destroy cancer cells or slow down the growth of cancer cells.

3. Radiotherapy: uses high-energy rays to kill cancer cells.

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Treatment Cont..4. Hormonal therapy:

If the cancer cells have hormone receptors, you may be prescribed hormone therapy drugs, such as blockers or inhibitors.

Both types of drugs help to destroy cancer cells by cutting off their supply of hormones.

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Prevention Breast cancer prevention begins with

various factors you can control. For example:

1. Control the weight

2. Get plenty of physical activity

3. Breast-feed.

4. Healthy diet.

5. Discontinue hormone therapy

6. Avoid exposure to environmental pollution

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Screening Breast cancer screening means

checking a woman's breasts for cancer before there are signs or symptoms of the disease.

Three main tests are used to screen the breasts for cancer.

1. Mammogram.

2. Clinical breast exam. A clinical breast exam is an examination by a doctor or nurse

3. Breast self-exam.

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Why women are more common to have breast cancer than men? there are several factors that

could explain why breast cancer is more common in women:

1. more breast tissue in women.

2. different hormone levels: estrogen and testosterone are present in both men and women, but at different levels.

3. menstruation.

4. lactation.

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How we can repair the breast after mastectomy? doctors can repair the

breast after mastectomy by breast reconstruction.

Breast reconstruction is a type of surgery for women who have had a breast removed (mastectomy).

The surgery rebuilds the breast mound so that it is about the same size and shape as it was before.

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Breast reconstruction

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References http://www.cancer.org/Cancer/BreastCancer/D

etailedGuide/breast-cancer-what-is-breast-cancer

http://www.nationalbreastcancer.org

http://www.cancer.org/cancer/breastcancer/moreinformation/breastreconstructionaftermastectomy/breast-reconstruction-after-mastectomy-what-is-br-recon

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Thank You