In stage I and II disease, the adjuvant radiotherapy decreases the risk of local recurrence, increase the disease free survival but the effect on overall survival is controversial
Breast cancer 2
Ectoderm: Epithelial lining of ducts and
Mammary Ridge: Develops from
ectoderm, at 5th week, from axilla to
Breast Bud: 10 years age.
Nipple: 12 years age.
• 2nd to 6th rib.
• Sternum to mid-axillary line.
• Two third over pectoralis major.
• One third over Serratus Anterior
• Divide breast into lobules.
• Connect deep fascia to skin.
• 15 to 20 lobues, drain into lactiferous ducts and then
Cutaneous branches of intercostal nerves
T4 to T6.
75% is to Axillary Lymph Nodes.
25% to Internal Mammary Nodes.
Sentinel Lymph Node.
One in eight women will develop breast
cancer in their lifetime.
Second most common cause of cancer
death among women overall(lung cancer is
Incidence increases with increasing age.
One percent of breast cancers occur in
Ductal Carcinoma In Situ
Lobular Carcinoma In Situ
Invasive Breast Cancer
• Invasive Ductal Carcinoma
• Invasive Lobular Carcinoma
• Mucoid Carcinoma
• Medullary Carcinoma
• Papillary Carcinoma
• Cribiform Carcinoma
History of breast disease
High alcohol intake.
5 to 10% of all breast cancers.
p53: A tumor suppressor gene.
Both BRCA1 and BRCA2 function as tumor-
BRCA1 and BRCA2 both are inherited in an
autosomal dominant fashion with varying
BRCA1: On 17q, also associated with ovarian
BRCA2: On chromosome 13q, also associated
with male breast cancer.
Somatic mutation of p53 in 50% and of Rb in
20% of breast cancers.
Clinical exmination, Histology and
Radiology discussed with MDT.
Decision for mastectomy documented.
Patient consented and counselled.
Ipsilateral arm abducted.
Examine breast before incision
Arm prepped and wrapped.
Upper and lower margins should be of
Incision away from obvious tumour