Breast cancer Presentation

1. BREAST
RELATED
DISEASES
NURAQILAH FATIN BINTI
MOHD DON ALFIAN
JOE LOH HONG PENG
WONG PINKY

2. CONTENTS
Anatomy of
breast
Presentation
of breast
disease
Approach to
breast lump
Approach to
nipple
discharge
Benign
breast
disease
Breast
cancer

3. ANATOMY OF BREAST

4. Is a modified sweat gland that is located
between the subcutaneous fat and the
fascia of pectoralis muscle and serratus
anterior muscle
Posterior to the breast and anterior the
pectoralis fascia is the retro mammary
space
Extends from 2nd to 6th rib
The axillary tail pierces the deep fascia
and enters the axilla

5. • Consists of 15-20 lobules of glandular tissue that
drains into lactiferous duct which converges towards
the nipple
• Lobules are separated by fibrous septa running from
the subcutaneous tissue to the fascia of the chest
wall (Cooper’s ligament)
- dimpling of the skin over a breast carcinoma is due to
malignant infiltration and contraction of the Cooper’s
ligament
• The areola is lubricated by the gland of Montgomery
(large modified sebaceous glands)

6. Blood supply to the breast
• Internal thoracic artery
- perforating branches
to anteromedial breast
• Axillary artery
• 2nd to 5th intercostal artery
Veins are corresponding to the
arteries

7. Lymphatic Drainage
• lymphatics of the breast drain predominantly into the
axillary and internal mammary lymph nodes.
• The axillary nodes receive approximately 85% of the
drainage and are arranged in the following groups:
 lateral, along the axillary vein;
 anterior, along the lateral thoracic vessels;
 posterior, along the subscapular vessels;
 central, embedded in fat in the centre of the axilla;
 apical, which lie above the level of the pectoralis minor
tendon in continuity with the lateral nodes

8. PRESENTATION OF BREAST
DISEASE

9. 1. Lump
- Painful or painless,
- Site of the lump
- Any changes of the size since 1st noticed
2. Nipple
- Any nipple discharge
- Retraction of nipple
- Nipple ulceration
3. Systemic review
- Loss of weight / loss of appetite / fever(infective cause) / Bone pain or SOB (mets)
4. Skin changes
- Peau-d orange of skin
- Ulceration over the mass

10. 5. Axillary lymph nodes enlargement
6. Oedema of the hand on the side of breast
carcinoma
7. History of trauma
- To rule out hematoma/ fat necrosis
8. History related to metastasis
9. Past history : history of diagnosed breast cancer/
radiation exposure
10. Gynaecological & obstetric history
- Age of menarche&menopause / age at 1st childbirth
/ marital status / breast feeding / hormone
replacement therapy
11. Family history
- Ovarian carcinoma / breast carcinoma / uterine
carcinoma