BREAST CANCER
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BREAST CANCER

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    BREAST CANCER BREAST CANCER Presentation Transcript

    • BREAST CANCER ULVAN OZAD STUDENT NUMBER: 090128053 BARTS AND THE LONDON SCHOOL OF MEDICINE AND DENTISTRY (1) (1)
    • CANCER and BREAST Cancer is a condition where body cells grow up and divide unmanageably; occupying and destroying the healthy tissue (MALIGNANT) RISK FACTORS: -Gender -Age -Family History -High hormone levels: HRT, menstrual problems... -Obesity -Alcohol (1) (2) (3)
    • TYPES OF BREAST CANCER NON-INVASIVE (IN SITU) INVASIVE OTHERS LOBULAR DUCTAL LOBULAR DUCTAL PAGET’S DISEASE OF NIPPLE/AREOLA INFLAMMATORY RARE TYPES MEN DIAGNOSIS (TRIPLE ASSESSMENT): -PALPITATION -RADIOLOGY (ULTRASOUND, MAMMOGRAPHY, MRI) -FINE-NEEDLE ASPIRATION Estrogen and progesterone receptor statuses are also important for classification and treatment (1) (4) (10)
    • PATHOLOGY -p53, BRCA1(chromosome 17), BRCA2(chromosome 13) mutations in error-correcting proteins -PI3K/AKT, RAS/MEK/ERK apoptosis prevention pathways mutation-“on” MOST COMMON: INVASIVE DUCTAL CARCINOMA (~70% OF CASES) (1) (3) (8) (8) (9)
    • STAGE 0 Non-invasive cell malformations STAGE 1 Tumour ≤2cm, Invasive breast cancer, early stage, invasion limited to breast STAGE 2 2A -Tumour absent/ Tumour ≤2cm, cancer present in axillary lymph nodes, no spread to body -2cm≤ Tumour ≤5cm, no cancer in axillary lymph nodes, no spread to body 2B - 2cm≤ Tumour ≤5cm, cancer present in lymph nodes, no spread to body -Tumour >5cm, no cancer in axillary lymph nodes, no spread to body STAGE 3 3A -Tumour absent/ 2cm≤ Tumour ≤5cm/ Tumour >5cm , cancer present in axillary and may be in lymph nodes near sternum 3B -Any size tumour, cancer present in skin or chest wall, cancer present in axillary lymph nodes or lymph nodes near sternum 3C -Any size tumour, cancer spread to lymph nodes near clavicle, , cancer present in axillary lymph nodes or lymph nodes near sternum STAGE 4 Spread to body (metastasis ) STAGES OF BREAST CANCER TYPICAL PRESENTATION: MASS IN BREAST, WITHOUT ANY PAIN (1) (3) (5)(6)(7)
    • IMPACT ON INDIVIDUAL AND SOCIETY INDIVIDUAL Emotions Body image Sexuality Relationships Motivation Activity Self-esteem Concentration Shame Stigma DEPRESSION SOCIETY Isolation Psychological Economic FAMILY AND FRIENDS Emotional Physical Economic IMPROVEMENT: INCREASE AWARENESS (38) (1)
    • WHY I CHOSE BREAST CANCER? 1)IT IS VERY IMPORTANT BREAST CANCER UK: -46,010 women per year DIAGNOSED (UK) -12,247 of this will DIE (UK) -1 in 8 women WILL have in lifetime -Most COMMONLY diagnosed cancer in <35 women(UK) -In last 10 years, incidence increased by 3.6% (UK) -In 2008, 1.38 million women diagnosed (WORLDWIDE) 2) EXPERIENCE 3)MY FUTURE PLAN -Reconstructive Surgery 4) INCREASE AWARENESS (1) (11)(20) (14)
    • CURRENT TREATMENT SURGERY LUMPECTOMY MASTECTOMY LYMPH NODE DISSECTION RADIATION THERAPY EXTERNAL INTERNAL Direct removal of tumour Radiation destroying cancer cells THERMAL THERAPY can be used together with radiotherapy (1) (12) (27) (28) (29) (30) (31) (32)
    • CURRENT TREATMENT CHEMOTHERAPY Cytotoxic medication damaging cancer cells ALKYLATING AGENTS PLANT ALKALOIDS ANTIMETABOLITES ANTITUMOUR ANTIBIOTICS TOPOISOMERASE INHIBITORS ANTINEOPLASTICS Can be given for NEOADJUVANT, ADJUVANT and PALLIATIVE management Depending on treatment, TRASTUZUMAB may be additionally used (1) (13) (17) (23) (24) (25) (10)
    • CURRENT TREATMENT HORMONAL (ENDOCRINE) THERAPY AROMATASE INHIBITORS SELECTIVE ESTROGEN RECEPTOR MODULATORS ESTROGEN RECEPTOR DOWNREGULATORS Blocking action or lowering concentration of estrogen in body Treat hormone-receptor- positive cancer TARGETED THERAPY HERCEPTIN (TRASTUZUMAB) TYKERB (LAPATINIB) AVASTIN (BEVACIZUMAB) Damage specific characteristics of cancer HOLISTIC MEDICINE is also used for symptomatic relief and eliminating side effects (1) (22) (26) (32) (32)
    • CURRENT TREATMENT - HOW EFFECTIVE? CANCER RESEARCH UK - MORTALITY -2008: 12.000 WOMEN, 70 MEN DIED IN UK 89.000 WOMEN DIED IN EUROPEAN UNION 458.000 WOMEN DIED IN THE WORLD -1.300 DEATHS PER YEAR- WOMEN UNDER 50 -IN UK, 2nd MOST COMMON COUSE OF WOMEN DEATH (31% OF ALL CASES) CANCER RESEARCH UK – SURVIVAL -INCREASE IN 10 YEARS SURVIVAL RATE FOR 32% IN 25 YEARS (1) (15) (15) (16) (16)
    • WHY NEW TREATMENT? SIDE EFFECTS OF CURRENT TREATMENT -CHEMOTHERAPY: HAIR CHANGES, ANAEMIA, INFECTION, MEMORY LOSS, BRUISING, BLEEDING, DIARRHOEA, NEUROPATHY, MOUTH SORENESS, FERTILITY PROBLEMS, NAIL CHANGES, NAUSEA, VOMITING, DEPRESSION... -RADIOTHERAPY: JOINT PAIN, SKIN PROBLEMS, FATIGUE, HEART PROBLEMS, BONE LOSS... -SURGERY: LYMPHADEMA, COSMETIC PROBLEMS, PSYCHOLOGICAL PROBLEMS, DEPRESSION, NERVE DAMAGE, SORENESS... -HORMONE THERAPY: WEIGHT GAIN, HOT FLUSHES, IMPOTENCE, NIGHT SWEATS, MUSCLE LOSS, FATIGUE, LOSS OF SEX DRIVE... -TARGETED THERAPY: WEAKNESS, PAIN, THERMAL FEELINGS, DIORRHEA, VOMITING, NAUSEA... WE WANT: -MINIMUM SIDE EFFECTS -MINIMUM COST -MINIMUM TREATMENT DURATION -MAXIMUM SURVIVAL RATE -MAXIMUM PATIENT HAPPINESS -MAXIMUM LIFE QUALITY (12) (1) (18) (19)(21)
    • IMPROVE SURGERY (SENTINEL NODE MAPPING) NEW AND FUTURE TREATMENTS UNDER RESEARCH (1) ONCOLYTIC VIRAL THERAPY INTERVENTIONAL RADIOLOGY GENE THERAPY VACCINES BREAST CANCER RESISTANCE GENE USAGE PRECISE DIAGNOSIS (33) (33) (33) (33) (34) (33) (33) CRYOTHERAPY NEW HORMONAL (ENDOCRINE) THERAPIES (35) TURNING CANCER INTO A CHRONIC DISEASE ANTI-VEGF THERAPY NEW CYTOTOXIC CHEMOTHERAPY FORMULATIONS (36) (36) NOVEL MICROTUBULE TARGETING AGENTS (36) (38)
    • IMPACT OF INTRODUCTION AND SUCCESS OF NEW TREATMENT (1) INTRODUCTION INCREASED DIAGNOSIS NEW HOPES PSYCHOLOGICAL IMPROVEMENT RESEARCH IMPROVEMENT INCREASED SHORT TERM COSTS SUCCESS INCREASED SURVIVAL DECREASED MORTALITY DECREASED SECONDARY DISEASES IMPROVED PSYCHOLOGY DECREASED LONG TERM COSTS DECREASED HOSPITALIZATION INCREASED SATISFACTION BETTER COSMETIC APPEARANCE FURTHER RESEARCH IMPROVED LIFE QUALITY IMPROVED LIFESPAN INDIVIDUAL FAMILY SOCIETY
    • SUMMARY (1) -CANCER OF BREAST TISSUE -STAGE 0: PREMALIGNANT, STAGES 1-3: GOOD PROGNOSIS, STAGE 4: METASTASIS -DISEASE HAS BIG IMPACT ON INDIVIDUAL, FAMILY AND SOCIETY -DIAGNOSIS RATES INCREASING, STILL VERY HIGH MORTALITY RATES -VARIOUS TREATMENT METHODS PRESENT, TREATMENT HAS IMPROVED IN THE LAST 30 YEARS -TREATMENT HAS SIDE EFFECTS AND IS STILL NOT ENOUGH SO NEW TREATMENTS ARE NEEDED -NEW DIAGNOSTIC AND SURGICAL METHODS, PHARMACEUTICAL DRUGS AND GENE TREATMENTS ARE UNDER RESEARCH -SUCCESSFUL IMPLEMENTATION OF NEW TREATMENTS WILL IMPROVE THE IMPACT OF CANCER ON INDIVIDUAL, FAMILIES AND SOCIETY (39)
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