WHAT IS BREAST?

>is a collection of glands and fatty tissue that

lies between the skin and the chest wall
> sit on the chest muscles that cover the ribs
>is made of 15 to 20 lobes
> also contain lymph vessels. These vessels
lead to small, round organs called lymph
nodes.
>The lymph nodes trap bacteria, cancer cells,
or other harmful substances.
 WHAT IS BREAST
CANCER?
>Also called the BREAST CARCINOMA
>An uncontrolled growth of breast cells
>a malignant tumor that starts from cells of the breast.
>happens when cells in the breast begin to grow out of
control and can then invade nearby tissues or spread
throughout the body. Large collections of this out of
control tissue are called tumors. However, some
tumors are not really cancer because they cannot
spread or threaten someone's life. These are called
benign tumors.
>Most commonly the cancer in women but it can also
happen to men.
 EPIDEMIOLOGY
• Breast cancer may be one of the oldest known forms
of cancer tumors in humans. The oldest description of
cancer (although the term cancer was not used) was
discovered in Egypt and dates back to approximately
1600 BC. The Edwin Smith Papyrus describes 8
cases of tumors or ulcers of the breast that were
treated by cauterization.The writing says about the
disease, "There is no treatment.”. For centuries,
physicians described similar cases in their practices,
with the same sad conclusion. It wasn't until doctors
achieved greater understanding of the circulatory
system in the 17th century that they could establish a
link between breast cancer and the lymph nodes in the
armpit.
• The French surgeon Jean Louis Petit
(1674-1750) and later the Scottish surgeon
Benjamin Bell (1749-1806) were the first
to remove the lymph nodes, breast tissue,
and underlying chest muscle. Their
successful work was carried on by
William Stewart Halsted who started
performing mastectomies in 1882. He
became known for his Halsted
radical mastectomy, a surgical procedure
that remained popular up to the 1970s.
William Stewart Halsted
Breast Cancer
Cell
Histopathologic image from
ductal cell carcinoma in
situ (DCIS) of breast.
Hematoxylin-eosin stain.

Typical macroscopic (gross)

appearance of invasive
ductal carcinoma of the
breast (pale area at the
center).
 TYPES OF BREAST
>
CANCER
Ductal carcinoma in situ (also known as intraductal
carcinoma), the cancer cells are inside the ducts but
have not spread through the walls of the ducts into
the surrounding breast tissue.
>LCIS (also called lobular neoplasia), it begins in the
milk-producing glands but does not grow through the
wall of the lobules.
>Invasive (or Infiltrating) Ductal Carcinoma (IDC) It
starts in a milk passage (duct) of the breast, has
broken through the wall of the duct, and invaded the
fatty tissue of the breast.
>Invasive lobular carcinoma starts in the milk-
producing glands (lobules).
 LESS COMMON TYPE
>Inflammatory breast cancer, the affected breast
may become larger or firmer, tender, or itchy.
>Mixed tumors are those that contain a variety of
cell types, such as invasive ductal cancer
combined with invasive lobular breast cancer.
>Medullary cancer is special type of infiltrating
breast cancer has a rather well-defined, distinct
boundary between tumor tissue and normal
tissue.
Metaplastic carcinoma(also known as carcinoma
with metaplasia) is a very rare variant of invasive
ductal cancer.
>Mucinous carcinoma(Also known as colloid
carcinoma), this rare type of invasive breast cancer
is formed by mucus-producing cancer cells.
>Paget disease of the nipple starts in the breast ducts
and spreads to the skin of the nipple and then to the
areola, the dark circle around the nipple.
>Tubular carcinoma are another special type of
invasive ductal breast carcinoma. It was named
tubular because of the way the cells look under the
microscope.
>Papillary carcinoma: The cells of these cancers
tend to be arranged in small, finger-like projections
when viewed under the microscope.
>Adenoid cystic carcinoma (adenocystic
carcinoma): These cancers are so named because
they have both glandular (adenoid) and cylinder-
like (cystic) features when viewed under the
microscope.
>Phyllodes tumor: This very rare breast tumor
develops in the stroma (connective tissue) of the
breast, in contrast to carcinomas, which develop
in the ducts or lobules. Other names for these
tumors include phylloides tumor and
cystosarcoma phyllodes. These tumors are usually
benign but on rare occasions may be malignant.
>Angiosarcoma is a form of cancer that starts
from cells that line blood vessels and also
occur in the arm of women who develop
lymphedema as a result of lymph node surgery
or radiation therapy to treat breast cancer.
>Male Breast Cancer
The male breast has less tissue mass than the
female, thus the tumor spreads rapidly and
infiltrates the underlying muscle and overlying
skin.
PHOTOS OF BREAST
CANCER
 ETIOLOGY
No one knows the exact causes of breast
cancer. Doctors often cannot explain why
one woman develops breast cancer and
another does not. They do know that
bumping, bruising, or touching the breast
does not cause cancer. And breast cancer is
not contagious. You cannot "catch" it from
another person.
 RISK FACTORS:
• Gender
• Early Breast Radiation
• Age
• Treatment with DES
• Genetic Risk Factors
• Family History
• Personal History of Breast Cancer
• Race
• Abnormal Breast Biopsy
• Mentrual Periods
 BREAST CANCER
RISK AND LIFESTYLE
• Not Having Children or Having Them Later in
Life
• Birth control pills
• Postmenopausal Hormone Therapy (PHT)
• Breast-feeding and Pregnancy
• Alcohol
• Being Overweight or Obese
• Exercise
UNCERTAIN RISK
FACTORS
• High Fat Diets
• Pollution
• Tobacco Smoke
• Night Work
• underarm antiperspirants
• Silicone breast implants
 SIGNS AND
SYMPTOMS
• a change in the size or shape of a breast
• dimpling of the skin of the breast
• a thickening in the breast tissue
• a nipple becoming inverted (turned in)
• a lump or thickening behind the nipple
• a rash (like eczema) affecting the nipple
• a bloodstained discharge from the nipple
(this is very rare)
• a swelling or lump in the armpit.
6 Breast Cancer Symptoms that
Most Women Don't
Know About
• Breast that is warm to the touch: A breast that
always feel warm, sometimes hot to the touch is a
symptom of inflammatory breast cancer, a
dangerous and rare type od the disease.
• Flat or inverted nipple: A nipple that is flat or
inverted is also a symptom of breast cancer. This
does not include having an inverted nipple since
birth.
• A breast that is often itchy: If you have itchy
breasts or nipples, talk to your doctor. These are
both symptoms of breast cancer.
• The skin around the breast is dimpled or looks
like an orange peel: Breast and surrounding skin
can take on a dimpled appearance, looking like an
orange peel. Many women are too embarassed to
show a doctor, thinking it is cellulite or from being
overweight. This is not the case.
• Swollen or breast that does not change with
menstrual cycle or size increase: It's normal for a
woman's breast to become swollen and tender
during a normal menstrual cycle, but when it's
constant, it need to be evaluated by a doctor.
Women also need to be aware of a sudden breast
size increase.
• Breast that is red or blotchy: A breast that is red
or blotchy, even having a rash-like appearance
should be evaluated by a doctor. It is a symptom
of inflammatory breast cancer. Inflammatory
breast cancer is a type of cancer that is often
undected by a mammogram and self breast exam.
 DIAGNOSIS
• Physical Examination
>visual inspection
>palpation
• Mammography is an x-ray of the breast that reveals
suspicious areas that are denser than normal breast
tissue or have abnormal deposits of calcium.
• Ultrasonography uses high frequency sound waves
that enter the breast and bounce back.
• Biopsy
>fine needle aspiration
>large core breast biopsy
>surgical biopsy.
 STAGING
• Carcinoma in situ is very early breast cancer.
Cancer has not invaded into the normal breast
tissue and is contained in either the breast duct
(ductal carcinoma in situ) or the breast lobule
(lobular carcinoma in situ). By definition, this
type of cancer is not invasive and is not able to
travel to the lymph nodes or other parts of the
body.
• Stage I means the tumor is no larger than two
centimeters (cm) (about one inch) and has not
spread outside the breast.
• Stage II means the tumor is from two to five
cm (roughly two inches) and/or has spread to
the lymph nodes under the arm.
• Stage III means the cancer is larger than five
cm (about two inches) involves the underarm
lymph nodes to a greater extent, and/or has
spread to other lymph nodes or other tissues
near the breast.
• Stage IV means the cancer has spread to other
organs of the body (metastatic cancer), most
often the lungs, bones, and/or liver.
 TREATMENTS
• Local treatments are used to remove or
destroy the cancer cells in a specific area.
Surgery and Radiation therapy are
examples of local treatments.
• Systemic treatments are used to destroy or
control cancer cells all over the body.
Chemotherapy and hormonal therapy
examples of systemic treatments.
 LOCAL TREATMENT
• Surgery
Lumpectomy: A surgical procedure to remove a
tumor (lump) and a small amount of normal
tissue around it.
Partial mastectomy: A surgical procedure to
remove the part of the breast that contains cancer
and some normal tissue around it. This procedure
is also called a segmental mastectomy.
Total mastectomy: A surgical procedure to
remove the whole breast that contains cancer.
This procedure is also called a simple
mastectomy.
 Modified radical mastectomy: A surgical procedure
to remove the whole breast that contains cancer, many
of the lymph nodes under the arm, the lining over the
chest muscles, and sometimes, part of the chest wall
muscles.
Radical mastectomy: A surgical procedure to remove
the breast that contains cancer, chest wall muscles
under the breast, and all of the lymph nodes under the
arm. This procedure is sometimes called a Halsted
radical mastectomy.
• Radiation therapy uses high energy rays (similar to
x-rays) to kill cancer cells. It comes from an external
source, and it requires patients to come in 5 days a
week for up to 6 weeks to a radiation therapy
treatment center.
 SYSTEMATIC
TREATMENT
• Chemotherapy is the use of anti-cancer drugs that go
throughout the entire body.
• Hormonal Therapy: When the pathologist examines
your tumor specimen, he or she finds out if the tumor
is expressing estrogen and progesterone receptors.
• Biologic Therapy: The pathologist also examines
your tumor for the presence of HER-2/neu
overexpression. HER-2/neu is a receptor that some
breast cancers express. A compound called Herceptin
(or Trastuzumab) is a substance that blocks this
receptor and helps stop the breast cancer from
growing.
 ANY VACCINES?
Unlike flu and many other vaccines, most
cancer vaccines under development are not
intended to be given to healthy people to
prevent disease. Rather, they help sick
patients bolster their immune system to
better fight the cancer

*NEUVENGE
*TAMOXIFEN
 COMPLICATIONS
AFTER TREATMENT
• MINOR COMPLICATIONS:
A) Slight swelling of the breast
B) The skin becomes darker during the
course of radiotherapy
C) Most women will have aches or pains
from time to time in the treated breast or
the muscles surrounding the breast
D) patients may develop a rib fracture
years following treatment
• MORE SERIOUS COMPLICATIONS:
A) Very rarely, patients develop a breakdown

of the skin, fractures of the sternum

(breastbone) or such severe pain in the
breast that surgery is needed for treatment.
B) Developing arm swelling ("lymphedema")
following axillary (armpit) dissection
C) Some patients develop "radiation
pneumonitis"
LIVING WITH BREAST
CANCER
• A woman who has breast cancer surgery or
treatment may not feel well for a while.
• She may be depressed if she had her breast
removed.
• She may lose her hair and she may feel sick
to her stomach.
• She also may worry that the cancer will
return and she'll get sick again.
 How many cases and
deaths
are estimated to
occur in
2007?
In 2007, an estimated 178,480 new cases of
invasive breast cancer will be diagnosed among
women, as well as an estimated 62,030
additional cases of in situ breast cancer (Table 2,
page 4).5 The expected number of new breast
cancers in 2007 is markedly lower than the
estimate for 2005 in the previous Breast
Cancer Facts & Figures report due to the
use of a new, more accurate estimation method
and a small decline in the breast cancer
In 2007, approximately 40,460 women are
expected to die from breast cancer (Table
2, page 4). Only lung cancer accounts for
more cancer deaths in women.
In 2007, about 2,030 cases of breast cancer
are expected to occur among men,
accounting for about 1% of all breast
cancers. Approximately 450 men will die
from breast cancer.
BREAST CANCER IN
THE PHILIPPINES
 PREVENTION
1. Pass on that last call for alcohol.
2. Quitters DO prosper - when it comes to
smoking.
3. Get physical/Regular aerobic exercise
4. Be aware of your family breast cancer
history.
5. Avoid hormone replacement therapy if
possible.
6. Check your breasts every month.
7. Try to keep a low fat diet/Your diet can
play an important role in breast cancer
prevention.

8. Don't forget to get a mammogram - it's not

a choice.
9. Have children earlier in life, if possible
10. Consider breastfeeding instead of formula
feeding.