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Presented b y: Katarina Bojanić Mentor: A. Žmegač Horvat

Presented b y: Katarina Bojanić Mentor: A. Žmegač Horvat. FACTS & EPIDEMIOLOGY. Most common malignancy in women (25-30%) 2nd leading cause of cancer deaths (after lung c.) > 570 , 000 new cases worldwide each year 2,300 new cases >800 deaths in Croatia (2005).

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Presented b y: Katarina Bojanić Mentor: A. Žmegač Horvat

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  1. Presented by: Katarina Bojanić Mentor: A. Žmegač Horvat

  2. FACTS & EPIDEMIOLOGY • Most common malignancy in women (25-30%) • 2nd leading cause of cancer deaths(after lung c.) • > 570,000 newcases worldwide eachyear • 2,300 new cases >800 deaths in Croatia (2005)

  3. Oneout ofeight womenwill be diagnosed • Strikes a small percentage of men • ≈1,500 new cases expected to be diagnosed in men next year

  4. Every three minutes a woman in the US is diagnosed with BC • Every 12 minutes a woman dies from BC • All women are at risk (rare in women <40; 10% of palpable masses malignant)

  5. Female Breast Anatomy • Each breast = 15 to20 sections (lobes) arranged like petals of daisy • Inside lobe = smaller structures (lobules) • End of each lobule = tiny sacs (bulbs), produce milk

  6. Lobes, lobules, bulbs- linked by network of thin tubes (ducts) • Carry milk: bulbs → dark area of skin (areola) Duct Areola

  7. Gender Age, Race Family/Personalhistory of BC Genetic factors Menstrual history Certain types of breast disease Radiation Weight (obesity) Exercise Alcohol Reproductive history Hormone replacement therapy Oral contraceptive use Breastfeeding Risk Factors Nonmodifiable risks Modifiable risks

  8. Genetic risk factors →10% of BC familial (hereditary) • BRCA 1&BRCA 2→ tumorsuppressor genes (breast cancer gene) →role in cellular DNA repair →mutation increasesrisk • P53, RAS, C-MYC, RB gene

  9. Types of Breast Cancer Invasive Cancers Noninvasive Cancers(in situ) spread from ducts or lobes into fatty tissue limited to ducts or lobes & does not spread into fatty tissue

  10. Detection methods • Self breast exam • Clinical examination • Mammography > 35 Ultrasound < 35 • Biopsy if indicated

  11. Mammography • X-ray picture of the breast to detect breast cancer • Detects a breast lump before it can be felt

  12. BIOPSY RESULTS • 80% of all breast biopsies turn out to be benign

  13. Clinical Breast Exam • Performed by doctor • Every 3 y. for women 20 – 39 • Yearly for women > 40 yrs of age

  14. Breast Self-Exam Monthly starting at the age of 20! • Still menstruating • 2-3 days after period ends • No longer menstruating • same day every month

  15. Two parts of BSE 1) Visual 2) Palpatory: • Examine each breast separately • Use pads of middle three fingers;feel the texture • Examine the armpits

  16. Patterns

  17. Visual: Most common: Lump or thickening in breast. Often painless Discharge or bleeding. Redness or pitting of skin over the breast; like the skin of an orange. Change in size or contours of breast. Change in color or appearance of areola.

  18. Abnormal Breast Changes Lump in the breast Changes in breast size of shape Notify Your Doctor Nipple discharged or tenderness Changes in the skin of the breast

  19. TREATMENT OPTIONS & PROGNOSIS • Depend on • Size of the tumor • Invasive or in situ • Histologic type - ductal (85%) vs. lobular • Estrogen/progesterone receptors (60-70%positive) • Her-2/ neu status (receptor for epidermal growth f.) tm size increases- chance decreases SURVIVAL

  20. Lymph node status • Spread to other parts of the body (bones, liver, lung, brain) • Age (premenopausal = poor prognostic factor)

  21. TREATMENT Goals Cure, Control, Palliation • Surgery • Radiation Therapy (local) • Chemotherapy (systemic) • Hormonal Therapy (systemic) • Immunotherapy 􀂄 Therapy is individualized

  22. SURGERY • Mastectomy (complete/radical) • Breast conservation (partial)

  23. RECONSTRUCTION

  24. RADIATION THERAPY Local control of disease Indications: • Adjuvant(after partial mastectomy) • Young patients with DCIS • High risk of local recurrence • High energy rays used to kill cancer cells

  25. CHEMOTHERAPY Anticancer drugs = systemic control of disease Indications: • After surgery to reduce risk of recurrence • Large + locally advanced cancer to reduce the size prior to surgery(neoadjuvant) • Metastatic - to reduce cancer that has spread + relieve symptoms & prolong life

  26. HORMONAL THERAPY • Hormones (blood stream) → attach ca.cells, promote their growth • Block the receptor or production of hormones ! • Side effects: hot flashes, depression, ↑risk of uterine cancer, induced manopause, blood clots • Tamoxifen, aromatase inhibitors...

  27. IMMUNOTHERAPY Monoclonal antibodies • Trastuzumab/Herceptin • Patients whose cancer cells over-express Her-2-neu oncogene as measured byIHC or FISH (25 to 30% of patients)

  28. Through early detection and improved treatments more women than ever are surviving breast cancer...

  29. THANK YOU FOR YOUR ATTENTION! Questions ?

  30. References: Kusić Z.Onkologija.Zagreb,2008 Damjanov I, Jukić S, Nola M.Patologija.Medicinska naklada,Zagreb, 2008 Kumar P, Clark M.Clinical Medicine.Saunders Elsevier,London,2007 www.cancer.org www.cancer.gov

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