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PATHOPHYSIOLOGY OF BREAST CANCER


PREDISPOSING FACTORS                                     ETIOLOGY                                    PRECIPITATING FACTORS
    Gender                                              (Unknown)                                           Diet
    Age                                                                                                     Hx of taking oral
    Genetics                                                                                                contraceptives
                                                                                                            Noncompliance to
                                                                                                            treatment
                                                                                                            Immunosuppression




                                          Genetic mutation of the cellular DNA
                                            (P53, BRCA-1, & BRCA-2 genes)




   Activation of growth-promoting            Inactivation of tumor suppressor            Alterations in the gene that
              oncogenes                                    genes                              controls apoptosis




                                      Unregulated proliferation and differentiation of
                                               cancer cells in the milk duct



                                              Growth of a malignant tumor



                                                             A
A




Activation of immunologic                               Release of growth factors
        mechanism                                                                              Cancer cells destroy
                                                                                                  normal RBCs

                                Cancer cells release         Angiogenesis
Release of B-lymphocytes,           exosomes
 T-lymphocytes & Natural                                                                      Anemia of Chronic disease
        Killer cells
                             Impairment of the immune            ↓ Lymphocytes
                                    response
                                                                                            ↓ RBC               Pale nail beds
Death of some Cancer cells                                                                  ↓Hgb               ↓ Capillary refill

                               Immunosuppression



                                  Pneumonia of                 Release of Neutrophils and
              Crackles          Immunosupression                     Macrophages

                                                                                                                           Malignant tumor grows
                                                                                                                                  rapidly
                                                                 Production of Pyrogenic
                               Productive cough
                                                                     cytokines: (IL-1)
                   DOB


                                                                                                        C                            B
                                                                          Fever
B




Change in symmetry or size                  Rapid multiplication of           Malignant tumor obstructs         Malignant tumor tends to compress
      of the breast                              cancer cells                       the milk duct                  blood and lymphatic vessels



                                                                                 Rupture of milk duct
                                          Rapid metabolism caused by
                                                the cancer cells
                                                                                                                  ↓ Blood supply to the
                                                                                                                      breast tissue
                                                                               Inflammatory response
                                          Normal cells are deprived of
           C                                      nutrients
                                                                                                                         Ischemia
                                                                                 Release of chemical
                                                                                      mediators:
                                                 Unexplained                 Bradykinins & Prostaglandins
                                                                                                                           Necrosis
                                                 weight loss


                      Fatigue                                                 Transient vasoconstriction
                      Limited ROM (3/5)                                                                                      F




                                                                                         D
                                                                                                                                              E
                                                                                                            G
D                                 E             F                 G




                       Vasodilation                 Blood and lymph stasis       Cancer cells begin to spread
                                                                                 locally via lymphatic vessels

                  ↑Vascular permeability
                                                                                   Presence of cancer cells in
                                                                                         lymph nodes
                Plasma fluid leaks into the
                          tissue

                                                                                    Palpable, immovable,
                        Swelling                           Tissue decay             hard & painless nodes:
                                                                                     Supraclavicular and
                                                                                     axillary lymph nodes
                                                                                             (2 cm)
                Compression of the nerve
                       endings                               Foul odor




                           Pain




 Accumulation of fluid, cells
and cellular debris & live and                Pus
     dead lymphocytes

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Pathophysiology of breast cancer (2)

  • 1. PATHOPHYSIOLOGY OF BREAST CANCER PREDISPOSING FACTORS ETIOLOGY PRECIPITATING FACTORS Gender (Unknown) Diet Age Hx of taking oral Genetics contraceptives Noncompliance to treatment Immunosuppression Genetic mutation of the cellular DNA (P53, BRCA-1, & BRCA-2 genes) Activation of growth-promoting Inactivation of tumor suppressor Alterations in the gene that oncogenes genes controls apoptosis Unregulated proliferation and differentiation of cancer cells in the milk duct Growth of a malignant tumor A
  • 2. A Activation of immunologic Release of growth factors mechanism Cancer cells destroy normal RBCs Cancer cells release Angiogenesis Release of B-lymphocytes, exosomes T-lymphocytes & Natural Anemia of Chronic disease Killer cells Impairment of the immune ↓ Lymphocytes response ↓ RBC Pale nail beds Death of some Cancer cells ↓Hgb ↓ Capillary refill Immunosuppression Pneumonia of Release of Neutrophils and Crackles Immunosupression Macrophages Malignant tumor grows rapidly Production of Pyrogenic Productive cough cytokines: (IL-1) DOB C B Fever
  • 3. B Change in symmetry or size Rapid multiplication of Malignant tumor obstructs Malignant tumor tends to compress of the breast cancer cells the milk duct blood and lymphatic vessels Rupture of milk duct Rapid metabolism caused by the cancer cells ↓ Blood supply to the breast tissue Inflammatory response Normal cells are deprived of C nutrients Ischemia Release of chemical mediators: Unexplained Bradykinins & Prostaglandins Necrosis weight loss Fatigue Transient vasoconstriction Limited ROM (3/5) F D E G
  • 4. D E F G Vasodilation Blood and lymph stasis Cancer cells begin to spread locally via lymphatic vessels ↑Vascular permeability Presence of cancer cells in lymph nodes Plasma fluid leaks into the tissue Palpable, immovable, Swelling Tissue decay hard & painless nodes: Supraclavicular and axillary lymph nodes (2 cm) Compression of the nerve endings Foul odor Pain Accumulation of fluid, cells and cellular debris & live and Pus dead lymphocytes