Please enable JavaScript.
Coggle requires JavaScript to display documents.
Unlucky Lump, depends on, include, include, include, consists of, whereby,…
Unlucky Lump
Anatomy of Breast
anatomical borders
transverse
lateral sternum to anterior axillary line
vertical
2nd to 6th ribs
breast parenchyma
15-25 lobes branching into lobules then alveoli
each lobe drained by lactiferous duct & each duct has a lactiferous sinus
breast supporting tissue
muscles
pectoralis major
serratus anterior
external oblique
rectomammary space
allows breast movement
suspensory ligaments of Cooper
supports mammary glands & attach them to skin
blood supply
medial mammary
internal thoracic
lateral mammary
lateral thoracic
axillary artery
thoracoacromial
histology
alveoli
simple cuboidal
surrounded by myoepithelial cells
lactiferous duct
simple coloumnar
lactiferous sinus
stratifies cuboidal
lactiferous duct near nipple opening
keratinized stratified squamous epithelium
TNM staging
Clinical staging
Pathologic staging
Biologic factors
HER 2
Histologic grade
Oncotype Recurrence score (RS)
ER -PR
Anatomic staging
lymph node assessment
Distant metastasis (M)
Tumor size (T)
https://www.uptodate.com/contents/tumor-node-metastasis-tnm-staging-classification-for-breast-cancer
Physiology of lactation
galactokinesis
Ejection of milk
Oxytocin
galactopoiesis
maintenance of lactation
lactogenesis
Initiation of milk secretion
Lactogenesis stage 1
Secretory activation
Lactogenesis stage 2
Prolactin
Mammogenesis
development of mammary glands
Estrogen and progesterone
Breast cancer
Invasive ductal carcinoma
Most common
Subtypes
Inflammatory
Mucinous
Tubular
Medullary
Lobular carcinoma in situ
Dyscohesive cells lacking E-cadherin
Bilateral multifocal
Ductal carcinoma in situ
Malignant proliferation of ductal cells
Microcalcifications
Invasive lobular carcinoma
Invades the basement membrane
Bilateral multifocal
Management
breast cancer surgery
Removing the breast cancer (lumpectomy)
Mastectomy
Sentinel node biopsy
Axillary lymph node dissection
Removing both breasts
after surgery
breast prosthesis
temporary
permanent
breast reconstruction
radiotherapy
side effects
Fatigue
Skin irritation
Breast swelling
aims
reduce recurrence
ease symptoms of metastatic breast cancer
pharmacological management
Chemotherapy
side effects
hair loss and thinning
fatigue
anaemia
bruising and bleeding
examples
doxorubicin
cyclphosamide
fluorouracil
hormone therapy
principle
only if cancer is estrogen receptor and progesterone receptor positive
MOA
Block action of estrogen on BC cells
Tamoxifen/ Toremifine
side effects
Fatigue
hot flashes
vaginal dryness
Antagonist action in breast but agonist in uterus
Fulvestrant
acts as anti-estrogen throughout body
Lower amount of estrogen in body
aromatase inhibitors
Letrozole, anastrozole
post-menopause
side effects
Arthralgia
Myalgia
Decrease bone density
targeted therapy
monoclonal antibodies against HER2 receptor
Trastuzumab (Herceptin)
Pertuzumab
Ado-trastuzumab emtansine
Benign lumps
Inflammatory conditions
Acute mastitis
Staphylococcus aureus
Breast feeding
Erythematous breast + purulent discharge
Periductal mastitis
Inflammation of subareolar ducts
Smokers
Vit A deficiency
Squamous metaplasia
Duct blockage and inflammation
Subareolar mass and nipple retraction
Duct ectasia
Inflammation with dilation of ducts
Multiparous postmenopausal women
peri areolar mass with green-brown nipple discharge
Chronic inflammation and plasma cells
Fat necrosis
Trauma
Mass
Abnormal calcifications
Necrotic fat with giant cells and calcifications
Fibrocytic changes
Cysts
Fibrosis
Aporcine metaplasia
Ductal hyperplasia
Sclerosing adenosis
Atypical hyperplasia
Benign tumours
Fibroadenoma
Fibrous tissue and glands
Most common benign tumour
Premenopausal
well-circumscribed, mobile marble-like mass
Oestrogen sensitive
No increased risk of carcinoma
Phyllodes tumour
Fibroadenoma
Overgrowth of fibrous component
Leaf-like projections
Post menopausal
Can be malignant in some cases
Genetic aspect
BRCA1/2
highly penetrant
early onset
Autosomal dominant
increase risk ovarian cancer
heterozygous females
TP53
Li- Fraumeni syndrome
higher risk of
multiple primary cancers in childhood
Premenopausal breast cancer
STK11
peutz jegher syndrome
absolute risk of breast cancer is 55%
depends on
include
include
include
consists of
whereby
which
which
branch of
branches of
of
lymphatic drainage
includes
options include
include
include
include
include
give therapy
example
include
it has
achieved by
example
used
include
include
Includes
Caused by
Occurs in
Presents as
Occurs in
Presents as
Usually have
Lead to
Result in
Occurs in
Presents as
On histology
Caused by
Present as
On mammography
On histology
Include
Are
Occurs in
Presents as
With
Leading to
Occurs in
includes
in
of developing
is the
is characterized by
is the
has
including
is characterized by
is
is characterized by
is
driven by
means
divided into
which is
which is
driven mainly by
