1. Laborator y Fr ontier s inBreast cancer scr eeningand diagnosisSejojo Phaaroe M.T; C.T(I.A.C); M.I.B.M.S
2. WHAT IS BREASTCANCER Breast cancer is a malignant (cancerous) tumor that starts from cells of the breast. The disease occurs mostly in women, but men can get breast cancer too In order to understand breast cancer, it is helpful to have some basic knowledge about the normal structure of the breasts
3. THE BREAST The breasts sit on the chest muscles that cover the ribs. Each breast is made of 15 to 20 lobes. Lobes contain many smaller lobules. Lobules contain groups of tiny glands that can produce milk. Milk flows from the lobules through thin tubes called ducts to the nipple. The nipple is in the center of a dark area of skin called the areola. Fat fills the spaces between the lobules and ducts.
4. ANATOMY –AND CYTOLOGY
5. Breast Tumors can bebenign or malignant : Benign tumors are not cancer: Benign tumors are rarely life-threatening. Generally, benign tumors can be removed. They usually do not grow back. Cells from benign tumors do not invade the tissues around them. Cells from benign tumors do not spread to other parts of the body.
6. Malignant tumors are cancer: Malignant tumors are generally more serious than benign tumors. They may be life-threatening. Malignant tumors often can be removed. But sometimes they grow back. Cells from malignant tumors can invade and damage nearby tissues and organs. Cells from malignant tumors can spread (metastasize) to other parts of the body. Cancer cells spread by breaking away from the original (primary) tumor and entering the bloodstream or lymphatic system. (angiogenesis) The cells invade other organs and form new tumors that damage these organs. The spread of cancer is called metastasis. The most common are the bones, liver, lungs, and brain.
7. Classification ofbenign tumors- onFNAB-Cytology Mastitis- Fibrocystic disease-(fluid-filled sacs) Few epithelial cells cystic material-serous or mucinous Adipose tissue Results from blockage of lobules and glands Necrotic debris Host cell response cells FIBROADENOMA Abundant epithelial cells-lobules and glands cystic material-serous or mucinous Fibro- Adipose tissue Apocrine metaplasia Necrotic debris Host cell response cells
8. Fibrocystic disease
10. Malignant mammarycancer Pagets disease- CAO of breast –skin Scirrhous adenocarcinoma Medullary adenocarcinoma Comedo adenocarcinoma Pappillary adenocarcinoma Lobular adenocarcinoma Sarcomas- rare
11. Malignancy with mitoticfigures
12. Risk factors High estrogen levels- exposure 2 out of 3 women with invasive breast cancer are age 55 or older when the cancer is found. ( predisposition to ovarian hormones in different cycles 5% to 10% of breast cancers are thought to be linked to changes (mutations) in certain genes The most common gene changes are those of the BRCA1 and BRCA2 genes Women with these gene changes have up to an 80% chance of getting breast cancer during their lifetimes Treatment with DES- In the past, some pregnant women were given the drug DES (diethylstilbestrol) because it was thought to lower their chances of losing the baby (miscarriage). Recent studies have shown that these women (and their daughters who were exposed to DES while in the womb), have a slightly increased risk of getting breast cancer High fat diet Obesity
14. Symptoms anddiagnosisfrom-lumps to swelling to skin Symptoms vary changes Many breast cancers have no obvious symptoms at all Symptoms that are similar to those of breast cancer may be the results of non-cancerous conditions like infection (mastitis) or cyst Breast self-examination should be part of your monthly health care routine Visit a Doctor when you can feel changes Women over 40 years are at high risk
15. Annual Physical examination by the physician Annual mammography The earlier the breast cancer is found and diagnosed the better your chances of beating it Laboratory tests can take weeks The other screening tests include The Magnetic Resonance Imaging-MRI scans- 90% detection when mammograph is missed Mammography- annual exams are useful Computer aided detection-CAD- (stereiotactic fibro- optic computer tomography)
16. Prevention studies-Trials Tamoxifen Raloxifene This was conducted with patients of risk of developing breast cancer Most research is based on evidence linking the development of the case with exposure to the estrogen hormone Above drugs are anti-estrogen like drugs Their anti-estrogen activity may help reduce the risk of breast cancer by blocking the effects of estrogen on breast tissue Postmenopausal women with a risk of developing cancer of breast