Breast cancer presentation

1. Breast cancer
Incidence
• Worldwide currently more than one million women
every year develop Breast Cancer.
• In USA and Europe 1 in 8 women develop Breast
Cancer in their lifetime.

2. Breast
cancer –
over 25% of
all cancers.
Highest of
all female
cancers in
2020

4. World Health Organisation 2022

5. Breast cancer in Sierra leone
• Among females, the commonest cancers were
Breast (25.1%), Cervix and Ovary combined (10%)
• Although Breast cancer is thought to be a disease of
the developed world, but almost 50% of Breast
cancer and 58% of deaths occur in less developed
countries.
• Up to 80% of women with Breast Cancer in Sub-
Saharan Africa are diagnosed in late stage (stage 3
or 4) resulting in a 5 year survival rate of <40%,
compared with >90% in the high-income countries.

6. Breast Cancer
• Risk factors

7. Breast cancer
Risk factors – Non Modifiable
• Female
• Age
• Family history (only less <10% of all Breast Cancer)
• Reproductive history

8. Breast cancer
Risk factors – Modifiable
Lifestyle factors-
• Alcohol
• Obesity
• Lack of physical exercise
HRT Long term use, Hormonal Contraceptive (rare)

9. Breast Cancer - presentation

10. Breast cancer - presentation
• Breast lump ( 90%)
• Recent change in shape and size of Breast
• Nipple retraction
• Bloody discharge from the nipple
• Lump under the armpit
• Pain

11. Breast examination
Lumps in
• 15-25 yrs – ANDI, Fibroadenoma
• 25-35 yrs – Fibroadenoma, Breast cyst,
Fibroadenosis, ? Cancer
• Over 35 - Cancer unless proved otherwise
Breast inflammation -
• 15-35 yrs - Breast abscess
• 35 yrs + - ? cancer

14. Inflammatory Breast cancer (IBC)
(Mastitis Carcinomatosa)
IBC is rare
and
accounts for
only 1-5% of
all breast
cancers.

15. Paget’s disease of the nipple
• A rare condition, usually in older
women, often associated with
Breast Cancer in the tissue
behind the nipple.
• It causes eczema-like changes
to the skin of the nipple and
areola.
• May be confused with eczema
which also causes red, itchy &
dry skin.
• If ulcer persisting after a few
weeks or associated with an
underlying lump likely Paget’s
disease

16. Breast cancer - diagnosis
• Clinical Breast examination
• Mammography and or Ultrasound
• Needle biopsy
(Triple Assessment)

18. Breast Cancer
Treatment
In an ideal set up, the diagnosis and treatment of breast
cancer is multidisciplinary.
Treatment involves:
• Surgery, Radiotherapy, Hormone therapy,
Chemotherapy and Biologic therapy.
A patient may need all or some of these.

19. Breast Cancer - Treatment
Local
Breast:
Surgery- Mastectomy
Lumpectomy followed by radiotherapy
Axilla – Surgery (sentinel node biopsy) / radiotherapy
Systemic
• Hormone Therapy
• Chemotherapy
• Biological therapy (Herceptin)

20. Breast cancer
Survival
Over 90 % can do very well after treatment
if treated early

21. Breast cancer
Can we prevent?
Yes - Can be prevented in almost 1 in 3 cases
• Avoid Alcohol
• Encourage Physical exercise
• Family history
• Breast awareness

22. Breast Cancer
Conclusion
• Common and rising
• Can be prevented up to 30%
• If diagnosed early with treatment very
good results possible
• We need champions in you