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Malignant Breast Disease Overview

This document discusses malignant breast disease, including its aetiological factors, pathology, nomenclature, Paget's disease, staging, and treatment options. The main points are: 1) Breast cancer risk factors include geographical location, age, gender, genetics, and endocrine factors like nulliparity and breastfeeding. 2) Breast cancer arises from the breast ductal or lobular epithelium. 3) Ductal carcinoma is most common, while inflammatory carcinoma is rare but aggressive. In situ carcinoma is preinvasive. 4) Paget's disease involves large clear cells in the nipple epidermis, presenting as eczema, and is associated with underlying breast cancer

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28 views20 pages

Malignant Breast Disease Overview

This document discusses malignant breast disease, including its aetiological factors, pathology, nomenclature, Paget's disease, staging, and treatment options. The main points are: 1) Breast cancer risk factors include geographical location, age, gender, genetics, and endocrine factors like nulliparity and breastfeeding. 2) Breast cancer arises from the breast ductal or lobular epithelium. 3) Ductal carcinoma is most common, while inflammatory carcinoma is rare but aggressive. In situ carcinoma is preinvasive. 4) Paget's disease involves large clear cells in the nipple epidermis, presenting as eczema, and is associated with underlying breast cancer

Uploaded by

ateequl69
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

Malignant Breast

Disease

Roll# 61 62 63
Aetiological Factors
• Geogrphical : occurs commonly in the western
world
• Age : rare before the age of 20
• Gender : less then 0.5% of patients with breast
cancer are male
• Genetic: more common in women with family
history of breast cancer
• Endocrine: breast cancer is more common in
nulliparous women and breast-feeding is
particular appears to be protective
Pathology
• Breast cancer may arise from the
epithelium of the duct system
anywhere from the nipple end of the
major lactiferous ducts to the
terminal duct unit which is in the
major lactiferous ducts to the
terminal duct Unit which is in the
breast lobule
Nomenclature
• Ductal carcinoma : is the most common variant
with lobular carcinoma occurring in upto 15%
of cases
• Inflammatory carcinoma : is the fortunately
rare highly aggressive cancer that presents as a
painful, swollen breast which is warm with
cutaneous oedema.
• In situ carcinoma : is preinvasie Cancer that
has not breached the epithelial basement
memberane . It may be ductal or lobular
Paget's Disease
• Paget's Disease of the nipple is superficial
manifestaion of an underlying breast carcinoma.
• It is characterized by the presence of large ovoid cells
with abdundant clear pale-staing cytoplasm in the
malpighian layer of the epidermis
• It presents as an eczema-like condition of the nipple
and areola, which persists despite local treatment
• The nipple is eroded slowly and eventually disappears
• . If left the underlying carcinoma will sonner or later
become cliniclly evident
Stagging of breast Cancer
Treatment
• The two basic principles of
treatment are to reduce the chance
of local recurrence and the risk of
metastatic spread
• 1 local treatment of early breast
cancer
• 2 Radiotherapy
• 3 Adjuvant systematic therapy
Local treatment
• 1 Surgery : Mastectomy is indicated for large tumors,
centeral tumors beneath or involving the nipple,
multifocal disease , local recurrence or patient
preference.
• Simple mastectomy involves removal of only the
breast with no dissection of the axilla
• Radical mastectomy (Halsted mastectomy) which
includes excision of the breast , axillary lymph nodes
and pectoralis major muscle. It is no longer indicated
• Modified Radical mastectomy (Patey mastectomy)
which includes excision of whole breast, all the fat ,
fascia and lymph nodes of the axilla
• 2 conservative breast surgery: this is
aimed at removing the tumor plus a
margin of normal breast tissue. This is
commonly referred to as a wide local
excision.
• 3 Sentinel node biopsy: this technique
has become the standard of care in the
management of the axilla in patients
with clinically node-negative disease
Radiotherapy
• Radiotherapy to the chest wall after
mastectomy is indicated in selected patients in
whom the risk of local recurrence are high
• It is conventional to combine conservative
surgery with radiotherapy to the remaining
breast tissue
Adjuvant systemic therapy
• The appropriate use of adjuvant chemotherapy
or hormone therapy will improve relapse-free
survival by approximately 30%
• Tamoxifen has been the most widely used
hormonal treatment in breast cancer
• Chemotherapy using a first-generation regime
such as a 6-monthly cycle of
cyclophosphamide, methotrexate and 5-
fluorouracil
Follow-Up of the breast cancer
• Patients with breast cancer used to be followed
for life to detect recurrence and dissemination.
• The current practice to arrange yearly or 2-
yearly mammography of the treated and
contralateral breast.

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