breast cancer
TRANSCRIPT
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Universidad de GuadalajaraCentro Universitario de Ciencias de la Salud
Departamento de Clínicas Quirúrgicas
Breast CancerDr. Benjamín Robles MariscalProfesor: Dr. Héctor Manuel Virgen AyalaBeatriz Tonántzin Gómez Fierro
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Epidemiology
The most common invasive cancer in women
2nd leading cause of death
99% 1%
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Risk Factors
White womenAge
Family historyBRCA1 or BRCA2 mutations (5-10%)Personal history of
breast or endometrial cancer
RadiationCertain breast changesBeing overweightPregnancy historyMenstrual historyAlcoholism
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Signs and Symptoms
A lump 70%Swelling of all or part of the breast
Skin irritation or dimpling
Breast pain
Nipple pain or the nipple turning inward
Redness, scaliness, or thickening of the nipple
or breast skin
A nipple discharge other than breast milk
A lump in the underarm area
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45%15%
25%
5% 10%
Frequency
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Diagnosis
Physical examination
Schwartz. Principios de cirugía. Mc Graw Hill. Vol I. 8va edición. Houston, Texas. P. 476
CBE
BSE
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Diagnosis
Screening testMammography
Ductography
Breast MRI
Ultrasound
PET scans
Chest X-rays
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Schwartz. Principios de cirugía. Mc Graw Hill. Vol I. 8va edición. Houston, Texas. P. 479.
CC MLO
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BI-RADSBreast Imaging Reporting and Data System
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I II III
IV V
MLO MLO CC
MLO
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Diagnosis
Biopsy
60% malignant lesions
30% benign lesions
Benign
Malignant
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Fine needle aspiration biopsy (FNA)
Core needle biopsy
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Excisional biopsy
Schwartz. Principios de cirugía. Mc Graw Hill. Vol I. 8va edición. Houston, Texas. P. 487
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Staging
T
N
M
Lymph node
Metastasis
Tumor
American Joint Committe on Cancer & International Union Against Cancer
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Histopathology
In situ
Invasive
Lobular (LCIS)
Ductal (DCIS)
Lobular (ILC)
Ductal (IDC)
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BiomarkersER 60%
PR 80%
HER-2/neu
VEGF
p53
nm23
DNA 5cER
u-PA
PAI-1
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Surgical techniques in breast cancer treatment
Excisional biopsy
Sentinel lymph node biopsy
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Lumpectomy
Mastectomy
Simple
Modified radical mastectomy
Halsted
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1 3
2
Schwartz. Principios de cirugía. Mc Graw Hill. Vol I. 8va edición. Houston, Texas. P. 489-491.
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Radiotherapy
Chemotherapy
Anti- estrogen therapy
Non surgical treatments
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Special clinical forms of breast cancer
Paget´s carcinoma
1%
Basic lesion
DCISLick, R. F. Atlas de patología quirúrgica. HARLA. México, D.F. 1981. P. 124-131.
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Inflammatory carcinoma
3%
Breast cancer during pregnancy or breastfeeding
Complicates one in 3000 pregnancies
Bilateral breast cancer
<5%
Lick, R. F. Atlas de patología quirúrgica. HARLA. México, D.F. 1981. P. 124-131.
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Male breast cancer
The average age of occurrence is close to 60 years
Clinical manifestations
A lump
A nipple discharge
Nipple retraction
Ulceration
Staging = Women
Modified radical mastectomy
Treatment
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Cancer stage
Prognosis
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Bibliography
Schwartz. Principios de cirugía. Mc Graw Hill. Vol I. 8º edición. Houston, Texas. P. 466-497.
M. Doherty, G. Diagnóstico y tratamiento quirúrgicos. Mc Graw Hall. LANGE. 13º edición. México, D.F. 2011. P. 244-262.
Lick, R. F. Atlas de patología quirúrgica. HARLA. México, D.F. 1981. P. 124-131.
http://www.breastcancer.org/
Elías, A. Contreras, A. Cáncer o Carcinoma de mama. Rev Pacena Med Fam 2008; 5(7): 14-23
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