Breast Cancer: An Overwiew

1. Breast Cancer: An Overview
DR.ABHISHEK K PATEL
ASSISTANT PROFESSOR
COMMUNITY MEDICINE
SARASWATI MEDICAL COLLEGE, UNNAO , U.P.
9September
2019
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2. What Is Breast Cancer?
 Breast cancer starts when cells in the breast begin to grow out of control.
 These cells usually form a tumor that can often be seen on an x-ray or felt as a
lump.
 The tumor is malignant (cancer) if the cells can grow into (invade) surrounding
tissues or spread (metastasize) to distant areas of the body.
 Breast cancer occurs almost entirely in women, but men can get breast cancer,
too.
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2019
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3. Symptoms of breast cancer
 a change in the size or shape of one or both breasts
 discharge from either of your nipples, which may be streaked with blood
 a lump or swelling in either of your armpits
 dimpling on the skin of your breasts
 a rash on or around your nipple
 a change in the appearance of your nipple, such as becoming sunken into your
breast
 Breast pain isn't usually a symptom of breast cancer 9 September
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4. Types of breast cancer
Breast cancer is often divided into:
 non-invasive breast cancer (carcinoma in situ) – found in the ducts of the
breast (ductal carcinoma in situ, DCIS) and hasn't developed the ability to spread
outside the breast. It's usually found during a mammogram and rarely shows as a
breast lump.
 invasive breast cancer – usually develops in the cells that line the breast ducts
(invasive ductal breast cancer) and is the most common type of breast cancer. It
can spread outside the breast, although this doesn't necessarily mean it has
spread. 9 September
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5. Where breast cancer starts
 Most breast cancers begin in the ducts that carry milk to the nipple
(ductal cancers).
 Some start in the glands that make breast milk (lobular cancers).
 It’s also important to understand that most breast lumps are benign and not
cancer (malignant).
 Non-cancerous breast tumors are abnormal growths, but they do not spread
outside of the breast and they are not life threatening.
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6. How breast cancer spreads
 Breast cancer can spread when the cancer cells get into the blood or lymph
system and are carried to other parts of the body.
 Most of the lymph vessels of the breast drain into:
1. Lymph nodes under the arm (axillary nodes)
2.Lymph nodes around the collar bone (supraclavicular [above the collar bone]
and infraclavicular [below the collar bone] lymph nodes
3.Lymph nodes inside the chest near the breast bone (internal mammary lymph
nodes)
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7. Lymphatics around Breast
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8.  If cancer cells have spread to your lymph nodes, there is a higher chance that the
cells could have traveled through the lymph system and spread (metastasized) to
other parts of your body.
 The more lymph nodes with breast cancer cells, the more likely it is that the
cancer may be found in other organs
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9. Disease Burden
 Breast cancer is now the most common cancer in most cities in India, and 2nd most common in
the rural areas.
 Breast cancer is the most common cancer in women in India and accounts for 14% of all
cancers in women .
 The incidence rates in India begin to rise in the early thirties and peak at ages 50-64 years.
 Overall, 1 in 28 women is likely to develop breast cancer during her lifetime.
 In urban areas, 1 in 22 women is likely to develop breast cancer during her lifetime as
compared to rural areas where 1 in 60 women develops breast cancer in her lifetime.
( Source: National Cancer Registry Programme 2017 )
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10. Risk Factors
 Family History
 Lifestyle- alcoholism, overweight, not being physically active
 Women who have not had children or who had their first child after age 30 have a
slightly higher breast cancer risk overall.
 Not breastfeeding
 Oral contraceptives
 Combined hormone therapy (HT)
 Silicone breast implants
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11. Breast Cancer Risk Factors You Cannot
Change
 Being a woman
 Getting older
 Certain inherited genes- BRCA1 and BRCA2
 family history of breast cancer
 personal history of breast cancer
 dense breast tissue
 Starting menstruation early
 menopause after age 55 year age 9 September
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12. Can I Lower My Risk of Breast Cancer?
 Get to and stay at a healthy weight
 Be physically active
 Limit or avoid alcohol
 Preventive surgery for women with very high breast cancer risk
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13. Early Detection and Diagnosis
 Clinical breast exam and breast self-exam
 Mammograms
1. Women between 40 and 44 years have the option to start screening with a
mammogram every year.
2. Women 45 to 54 years should get mammograms every year.
3. Women 55 years and older can switch to a mammogram every other year.
 Other Imaging Tests to Find Breast Cancer-USG, MRI Scan
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14. Staging
Stage 0
 Stage 0 cancer means that the cancer is limited to the inside of the milk duct and
is a non-invasive cancer. The treatment approaches for these non-invasive breast
tumors are often different from the treatment of invasive breast cancer. Stage 0
breast tumors include ductal carcinoma in situ (DCIS).
 Lobular carcinoma in situ (LCIS) used to be categorized as Stage 0 but this has
been changed, because it is not cancer, but does indicate a higher risk of breast
cancer.
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15.  Stage I: These breast cancers are still relatively small and either have not spread
to the lymph nodes or have only a tiny area of cancer spread in the sentinel lymph
node (the first lymph node to which cancer is likely to spread).
 Stage II: These breast cancers are larger than stage I cancers and/or have spread
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16.  Stage III: These tumors are larger or are growing into nearby tissues (the skin
over the breast or the muscle underneath), or they have spread to many nearby
lymph nodes.to a few nearby lymph nodes.
 Treatment for stages I to III breast cancer usually includes surgery and radiation
therapy, often along with chemo or other drug therapies either before or after
surgery.
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17. Stage IV (metastatic breast cancer)
 Stage IV cancers have spread beyond the breast and nearby lymph nodes to other
parts of the body. Treatment for stage IV breast cancer is usually a systemic
(drug) therapy.
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18. Breast Reconstruction Options
 Using silicone or saline breast inserts (known as breast implants)
 Using your own body tissues (known as tissue flap procedures)
 In addition, nipple/areola tattooing and fat grafting can be done to help make the
reconstructed breast look more like the original breast. The reconstructed nipple
and areola do not have any sensation.
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19. Follow up Care After Breast Cancer
Treatment
Typical follow-up schedules
 Doctor visits:
 Mammograms:
 Pelvic exams:
 Bone density tests:
 Other tests-bone scans and chest x-rays
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20. There’s no way that in the end that cancer is going to beat me. I
need to beat this because I do have a family and that’s what I live for.
Matt Blennau - Cancer Survivor
Thankyou 9 September
2019
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