Breast Cancer

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Amirah Zainab Binti Mamat@Muhammad

10-3-41

NORMAL BREAST HISTOLOGY]. Breast can be considered a modified skin appendage in Mammalians producing producing milk for the nourishment of the newborn. The milk is discharged from a

collection 10-20 large ducts opening through pores in the the breast nipple tissue duringforming lactation. Each large duct, also of called lactiferous duct, branches out deep into what is called  a breast lobe. Thus, a breast consists of about 10-20 inter-ana inter-anastomosing stomosing lobes separated from each other b !aring amounts of fibro-adipose tissue. This photomicrograph shows si" #$% lactiferous lactiferou s ducts #arrows% that run from the nipple to branch down into successi!e smaller ducts until the formation of &t erminal erminal duct lobular unit #T'()%.* 

Incidence Breast cancer is the leading cause of death in women over 40 years. Approximately 1 woman in 13 ( nearly 8! will develop "reast cancer during her lifetime. Breast cancer  is a malignant tumor that starts in the cells of the "reast. A malignant tumor is a group of  cancer cells that can grow into (invade! surrounding tissues or spread (metastasi#e! to distant areas of the "ody. $he disease occurs almost entirely in women% "ut men can get it% too.

Definition of breast cancer & 'ancer that forms in tissues of the "reast% usually the ducts (tu"es that carry mil to the nipple! and lo"ules (glands that mae mil!. )t occurs in "oth men and women% although male "reast cancer is rare. Estimated new cases and deaths  from "reast cancer in the *nited +tates in ,01,& •

-ew cases& ,,%8/0 (female! ,%10 (male!



2eaths& 3%10 (female! 410 (male!

 

Amirah Zainab Binti Mamat@Muhammad

10-3-41

Etiology- unnown% "ut there are , important factors 1. ene eneti tic c fa fact ctor ors s ,. 5o 5orm rmon onal al fa fact ctor ors s  Accordingly  Accordin gly "reast "reast cancer cancer is either either hereditary hereditary or sporadic sporadic

Pathogenesis  Hereditary breast carcinoma • • •





 Associated with family history  Associated history or germ germ line mutation mutation $here are multiple mutations including 1.B6'A17 B6'A,( tumor suppressor genes!detected in familial "reast cancer  cases 5er ,neu( '9erB,!this genes is a mem"er of epidermal growth factor receptor  family and its over expression is associated with poor prognosis in patients with lymph node positive "reast cancer. 6" and p3

Sporadic breast carcinoma 'ause9 estrogen plays an important role in the development of "reast cancer. $here is an evidence of an increased ris in patient with estrogen producing ovarian tumors . estroge estr ogen n stim stimulat ulates es prod producti uction on of grow growth th fact factors ors "y nor normal mal and neo neoplas plastic tic "rea "reast st epithelial cells.

Sites • •

• •

 Affects the left "reast slightly  Affects slightly more more than the the right% "ilateral in 4 cases. cases. 0 of cases arise in upper outer :uadrants of the "reast "ecause most of  normal glandular tissue of the "reast is located in this area. ,0 of central area 30 in the remaining three :uadrants

Sites of metastasis   A"out A"out ,0 of women are diagnosed diagnosed at the very earliest stage ("efore the cancer has moved "eyond a "reast duct or ducts to invade surrounding "reast tissue!. Another /0 learn of their cancer while it;s still contained within the "reast or draining lymph nodes. Both groups have good prospects of avoiding metastasis altogether. <nly 10 are diagnosed after the cancer has already progressed to distant areas% which for "reast malignancies typically includes the "ones% lungs% liver or "rain. =etastat =etast atic ic cance cancerr typic typicall ally y develo develops ps (if at all all!! withi within n 3 years years of the the initi initial al cance cancer  r  treatment% often invading lymph nodes near the "reast 99 located in the armpit and chest wall 99 "efore traveling farther sites. again% depends the recurrence grade and aggressiveness of each to individual tumor%But with somemuch carrying much on higher

 

Amirah Zainab Binti Mamat@Muhammad

10-3-41

rates. A"out a :uarter of all metastases first appear in the "ones. $he lungs (at a"out ,0!% liver and "rain (the latter two accounting for a"out 1 each! are next most common sites for cancer spread. =etastasis may cause symptoms in the area where the cancer has newly appeared. Bone metastases (the most common type! can produce "one pain lung metastases can produce coughing coughing or shortness shortness of "reath and liver metastas metastases es can produce depressed depressed appetite and weight loss. A "rain metastasis may cause neurological symptoms% such as headaches% "lurry vision or a feeling of weaness.

Ways of spread Breast cancer spreads spreads in three different different ways 99 through the lymph system% which is the most common through the "lood or through tissue% as when a tumor grows into% or  invades% surrounding normal cells. )f another tumor forms elsewhere in the "ody through metastasis% it;s the same ind of cancer as the original tumor. A new tumor in the lung% for instance% is considered metastatic "reast cancer% not lung cancer. 5owever% these metastasi#ed tumors tend to "e more aggressive than the original "reast tumor.

References

http&www."reastcancer.org http&www.we"md.com"reast9cancerdefault.htm http&www.medicinenet.com"reast>cancerarticle.htm http&en.wiipedia.orgwiiBreast>cancer  http&www.nc"i.nlm.nih.govpu"medhealth?=5000111 http&www.cancer.govcancertopicstypes"reast http&www.cancer.orgcancer"reastcancerindex 1.

'arls 'arlson on 6@% 6@% Allred llred 2'% 2'% Ande Anderso rson n B<% B<% Burst Burstein ein 5% 5% 'arte 'arterr @B% dge dge +B% +B% et al. al. Breast cancer. 'linical practice guidelines in oncology. + atl ompr anc etw . ,00 Ce"/(,!&1,,9,. ,. 'hle" 'hle"ow ows sii 6$% 6$% Dull Duller er E5% E5% ?renti ?rentice ce 6E% 6E% +tef +tefani anic c =E% =E% =anso =anson n % % ass ass =% et al. Breas Breastt cance cancerr after after us use e of estro estrogen gen plus plus proge progest stin in in post postmen menop opaus ausal al women.  Engl + Med . ,00 Ce" 30(!&/398/. 3. 5ayes 5ayes 2C. 2C. 'lini 'linica call practic practice. e. Collo Collow9 w9up up of patien patients ts with with early early "reas "reastt cancer cancer..   Engl + Med . ,00/3(,4!& ,0913. 4. oss oss ?% ?% )ngl )ngle e -% AlF AlFs9 s9=a =art rtGn Gne# e# % et al. xem xemes esta tane ne fo forr "rea "reast st9c 9can ance cer  r  prevention in postmenopausal women. - ngl  =ed. ,011 un ,334(,!&,3819 1.

 

Amirah Zainab Binti Mamat@Muhammad

10-3-41

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Ea'roix Ea'roix AH% AH% 'hle" 'hle"ows owsi i 6$ 6$% =anson =anson % et al. al. 5eal 5ealth th outco outcomes mes after after stopp stopping ing co conI nIug ugat ated ed e:ui e:uine ne estr estrog ogen ens s amon among g post postme meno nopa paus usal al wome women n wi with th prio prior  r  hysterectomy& a randomi#ed controlled trial. A=A. ,011 Apr 30(13!&130914. . i iul ulia iano no A% A% 5unt 5unt DD% DD% Ball Ballma man n DJ% DJ% et al. Axi Axill llar ary y disse dissect ctio ion n vs no axill axillar ary y dissection dissect ion in women with invasive "reast cancer and sentinel node metastasis& a randomi#ed clinical trial. A=A. ,011 Ce" 30(!&9/. /. 'hle 'hle"o "ows wsi i 6$% 6$% And Ander erso son n E% ass ass =% et al. stro stroge gen n plus plus proge progest stin in and and "reast cancer incidence and mortality in postmenopausal women. A=A. ,010 <ct ,0304(1!&1849,. 8. @arn @arner er . 'lini 'linica call practi practice ce.. Breas Breast9c t9canc ancer er scree screeni ning. ng. - ngl ngl  =ed. =ed. ,011 ,011 +ep +ep 13(11!&10,93,. . 'u#i 'u#ic c % 2e'e 2e'ens nsii A% Aru Arun n B% et al. al. ?reve ?revent ntiv ive e thera therapy py for for "reas "reastt cance cancer& r& a consensus statement. Eancet <ncol. ,011 =ay1,(!&4903. 10. 'halasa 'halasani ni ?% ?% 2owne 2owney y E% +topec +topec A$ A$. 'aring 'aring for the the "reast "reast cancer cancer survivor& survivor& a guide for primary care physicians. Am  =ed. ,010 un1,3(!&489.

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