Etiology and Staging of Breast Ca

1. BREAST CARCINOMA

2. • Second most carcinoma in females
• Incidence – 19% to 34%
• Common after middle age

3. Etiology
• Familial (2%-5%)
• Mutation of tumour suppressor gene
– BRCA 1
– BRCA 2
• Diet
• Nulliparous female
• Obesity

4. • Early menarche and late menopause
• Early child bearing and breast feeding
• Gynaecomastia
• Cowden’s syndrome
• Radiotherapy
• Radial scar
• OCPs and HRT

5. Concepts
• Halstead concept
• Fischer concept
• Spectrum concept

6. • Nuclear pleomorphism
• Mitotic count
• Tubule formation
Grading system

7. TNM Staging of Ca Breast
• Tx – Tumour cannot be assessed
• T0 – No evidence of primary
• Tis – Carcinoma insitu
• T1 – Tumour size < 2cm
• T2 – Size 2 – 5cm
• T3 – Size > 5cm
• T4 – Fixed to chest wall or skin

8. • Nx – Nodes cannot be assessed
• No – No nodes
• N1 – Axillary nodes
• N2a – Axillary nodes ipsilateral fixed to
one another and other structures
• N2b – Clinically apparent and
ipsilateral Internal mammary nodes in
the absence of clinically palpable
axillary nodes

9. • N3a – Spread to ipsilateral
infraclavicular lymph nodes with or
without axillary nodes
• N3b – Spread to ipsilateral internal
mammary nodes and axillary nodes
• N3c – Spread to ipsilateral
supraclavicular lymph nodes with or
without axillary or internal mammary
nodes

10. • Mx – Metastasis cannot be assessed
• M0 – No metastasis
• M1 – Distant metastasis