breast cancer lecture by roel tolentino, md, mba

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Breast Cancer Breast Cancer Awareness Forum Awareness Forum

Roel S. Tolentino, MD, MBA, Roel S. Tolentino, MD, MBA, FPCS,FPCS, FACS, FPSO, FPSGS, FMOSPFACS, FPSO, FPSGS, FMOSP

General Surgery – Surgical OncologyGeneral Surgery – Surgical Oncology

Past President- Philippine Society of Oncology Past President- Philippine Society of Oncology Professor of Surgery IVProfessor of Surgery IV

Memorial Sloan Kettering Cancer Center (NYC)University Hospitals of Columbia University and Cornell Medical College (NYC)MD Anderson Cancer (Texas)Beijing Cancer Hospital (China)Chongqing Medical University (China)Suining Central Hospital (China)

De La Salle University – De La Salle University – BS. BS. Biology; MedicineBiology; Medicine

Manila Med – Manila Med – General SurgeryGeneral Surgery

SLMC – SLMC – Surgical OncologySurgical Oncology

Ateneo GSB - Ateneo GSB - MBAMBA

Prof. Roel Tolentino, MD, MBA

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• BREAST CANCER IS THE NO. 1 CANCER IN THE PHILIPPINES!

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Mastitis

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12Intraductal papilloma

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Virginal Hyperplasia

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Silicon Mastopathy

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Anatomy

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Anatomy

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Galactorrhea (paglabas ng gatas)

24Hematoma (pasa)

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Fibrocystic changes

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Fibroadenoma and Cyst

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Phyllodes Tumor

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Gynecomastia

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Pubertal Gynecomastia

(binatang nagdadalaga)

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Failure of Breast Development

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Breast Augmentation

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Breast Augmentation

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Breast Augmentation

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Clinical Examination

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Physical Examination

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Palpation in circular or radial fashion

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Diagnostic Tests

•Mammography

•Ultrasound

•Needle Aspiration Biopsy

•Excision Biopsy

•Magnetic Resonance Imaging (MRI)

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Mammography

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Mammography

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Diagnostics•Mammography

Cranio-caudal view

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Diagnostics•Mammography

Oblique View

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Mammography

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Mammography

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Mammography

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Digital Mammography

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Ultrasound

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Tomosynthesis

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BIOPSY

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Needle Biopsy

63Technique of Fine Needle Aspiration

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Excision Biopsy

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Open Surgical Biopsy

Percutaneous Biopsy

Biopsy

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Magnetic Resonance Imaging

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Magnetic Resonance Imaging

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BREAST CANCER

- Most common cancer in

the Philippines!

( Metro Manila and Rizal registry)

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Risk Factors for Breast Cancer

• Gender

• Aging

• Genetic risk factors/Family history

• Personal history of breast cancer

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Risk Factors for Breast Cancer

• Race

• Previous abnormal breast biopsy

• Previous breast radiation

• More menstrual periods

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Risk Factors for Breast Cancer

• Not having children

• Hormone replacement therapy

• Alcohol

• Obesity and high-fat diets

• Less physical activity

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Factors with Uncertain, Controversial, or Unproven Effect on Breast Cancer Risk

• Antiperspirants

• Underwire bras

• Abortion

• Breast implants

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Early detection for breast cancer:

• 20 years or older20 years or older–Breast self examination (BSE)

monthly.

• 20-40 years old20-40 years old–BSE monthly.–Physician breast examination every

3 years.

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Early detection for breast cancer:

• An initial mammogram between the age of 35-40 years35-40 years.

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Early detection for breast cancer:

• 40-50 years old40-50 years old–BSE monthly.

–Annual physician breast examination.

–Periodic mammography every year or two as determined by personal history and doctor's recommendation.

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Early detection for breast cancer:

• Over 50 years of ageOver 50 years of age–BSE monthly.

–Annual mammography and physician breast examination.

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Signs of Cancer(Mass)

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Signs of Cancer(Nipple Retraction)

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Signs of Cancer(Distortion)

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Signs of Cancer(Peau d’orange)

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Signs of Cancer(Distortion, Nipple Retraction)

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Signs of Cancer(Bloody Nipple Discharge)

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Signs of Cancer(Scaling)

Paget’s Disease

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Signs of Cancer(Asymmetry)

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Redness

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Signs of Cancer(Ulceration)

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Breast Cancer with Ulcerations

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Operations for Breast Cancer

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Locally Advanced Breast Cancer

After neoadjuvant therapy

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Modified Radical Mastectomy

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Breast Conserving Surgery

-Lumpectomy

-Axil lary Dissection

-Radiation Therapy

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Breast Reconstruction

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Chemotherapy

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CHEMOTHERAPY

-a systemic treatment-4-6 cycles-given every 21/28 days-done as outpatient basis

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Radiation Therapy

Linear Accelerator

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Recurrence

TREATMENTS

• CURATIVE

• PALLIATIVE

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Disseminated Breast Cancer

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WAYS TO DECREASE WAYS TO DECREASE THE RISK FOR THE RISK FOR BREAST CANCER?BREAST CANCER?

Breast Cancer

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Early detection is the best.

Awareness of the signs and symptoms is very important.

Go to your doctor when you have any problem with your breast.

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roel_tolentino@yahoo.com

North 909, SLMC QCM-W-F 3-5 pm09164079417, 788-1412