This document summarizes the anatomy, pathology, and epidemiology of breast cancer. It discusses the embryology, gross anatomy, histology, and molecular classification of the breast. It also describes the epidemiology of breast cancer, noting key risk factors like family history, age, reproductive history, hormone exposure, radiation exposure, BMI, physical activity, and diet. Screening and management of breast cancer is available at various levels of healthcare centers in India.
The document discusses the anatomy of the breast. It covers topics such as location and extent of the breast, layers and structures within the breast like skin, parenchyma, ducts and lobes. It also discusses blood supply, lymphatic drainage including lymph node stations, nerve supply and radiological anatomy of the breast.
Riedel's lobe is a normal anatomical variant where the right lobe of the liver extends inferiorly beyond the costal margin. It presents as a tongue-like projection off the right lobe. While its prevalence was originally reported between 3-31%, more recent studies show it occurs in around 25-60% of individuals between ages 20-65 due to age-related changes in liver size and skeletal shape. Though typically benign, Riedel's lobe can be mistaken for a mass and its recognition is important to avoid unnecessary workup or ensure complete imaging of the liver. It may also impact surgical procedures in the right upper abdomen.
Presentation1.pptx, radiological anatomy of the abdomen and pelvis.Abdellah Nazeer
This document discusses various imaging modalities used to image the abdomen and pelvis, including ultrasound, CT, MRI, fluoroscopy, and nuclear medicine scans. It provides details on how each modality works and examples of images produced. Key anatomy seen on plain films is described. The primary modalities are said to be ultrasound, CT and plain films. Choice of modality depends on clinical presentation and physical exam findings. Understanding anatomy aids in interpreting imaging studies.
This document contains a series of unlabeled CT scan images of the abdominal cavity and its contents. Brief annotations are provided for some images identifying key structures like the liver, stomach, intestines, blood vessels and muscles. The images appear to be from different angles and reconstructions including coronal, sagittal, and possibly 3D views of the abdomen.
The document describes the anatomy of the larynx based on a radiology report. It discusses the boundaries and divisions of the larynx and describes the cartilages that make up the laryngeal framework, including the thyroid, cricoid, and arytenoid cartilages. It also summarizes the imaging appearance of the larynx on computed tomography (CT) and magnetic resonance imaging (MRI).
This document provides information on supratentorial brain tumors, including:
1. It describes the normal anatomy of the brain including the supratentorial and infratentorial components.
2. It discusses the incidence, classification, and common signs/symptoms of supratentorial tumors.
3. It outlines the diagnostic workup for brain tumors including imaging studies, biopsy procedures, and cytology examinations.
The document discusses the anatomy and divisions of the mediastinum. It is divided into superior, anterior, middle and posterior compartments by imaginary lines. The superior mediastinum contains structures like the thymus, great vessels and nerves. The anterior mediastinum contains the thymus and lymph nodes. The middle mediastinum contains the heart and great vessels. The posterior mediastinum contains the esophagus and descending aorta. Common mediastinal tumors are discussed along with their locations.
The document describes the arterial blood supply of the gastrointestinal tract. It details the branches and territories of the superior and inferior mesenteric arteries. The superior mesenteric artery supplies the midgut, including parts of the small intestine, right colon, and pancreas. It gives off branches like the intestinal, ileocolic, right colic, and middle colic arteries. The inferior mesenteric artery supplies the hindgut, including parts of the left colon, sigmoid colon, and rectum. Its branches include the left colic, sigmoid, and superior rectal arteries.
The document discusses the anatomy of the breast. It covers topics such as location and extent of the breast, layers and structures within the breast like skin, parenchyma, ducts and lobes. It also discusses blood supply, lymphatic drainage including lymph node stations, nerve supply and radiological anatomy of the breast.
Riedel's lobe is a normal anatomical variant where the right lobe of the liver extends inferiorly beyond the costal margin. It presents as a tongue-like projection off the right lobe. While its prevalence was originally reported between 3-31%, more recent studies show it occurs in around 25-60% of individuals between ages 20-65 due to age-related changes in liver size and skeletal shape. Though typically benign, Riedel's lobe can be mistaken for a mass and its recognition is important to avoid unnecessary workup or ensure complete imaging of the liver. It may also impact surgical procedures in the right upper abdomen.
Presentation1.pptx, radiological anatomy of the abdomen and pelvis.Abdellah Nazeer
This document discusses various imaging modalities used to image the abdomen and pelvis, including ultrasound, CT, MRI, fluoroscopy, and nuclear medicine scans. It provides details on how each modality works and examples of images produced. Key anatomy seen on plain films is described. The primary modalities are said to be ultrasound, CT and plain films. Choice of modality depends on clinical presentation and physical exam findings. Understanding anatomy aids in interpreting imaging studies.
This document contains a series of unlabeled CT scan images of the abdominal cavity and its contents. Brief annotations are provided for some images identifying key structures like the liver, stomach, intestines, blood vessels and muscles. The images appear to be from different angles and reconstructions including coronal, sagittal, and possibly 3D views of the abdomen.
The document describes the anatomy of the larynx based on a radiology report. It discusses the boundaries and divisions of the larynx and describes the cartilages that make up the laryngeal framework, including the thyroid, cricoid, and arytenoid cartilages. It also summarizes the imaging appearance of the larynx on computed tomography (CT) and magnetic resonance imaging (MRI).
This document provides information on supratentorial brain tumors, including:
1. It describes the normal anatomy of the brain including the supratentorial and infratentorial components.
2. It discusses the incidence, classification, and common signs/symptoms of supratentorial tumors.
3. It outlines the diagnostic workup for brain tumors including imaging studies, biopsy procedures, and cytology examinations.
The document discusses the anatomy and divisions of the mediastinum. It is divided into superior, anterior, middle and posterior compartments by imaginary lines. The superior mediastinum contains structures like the thymus, great vessels and nerves. The anterior mediastinum contains the thymus and lymph nodes. The middle mediastinum contains the heart and great vessels. The posterior mediastinum contains the esophagus and descending aorta. Common mediastinal tumors are discussed along with their locations.
The document describes the arterial blood supply of the gastrointestinal tract. It details the branches and territories of the superior and inferior mesenteric arteries. The superior mesenteric artery supplies the midgut, including parts of the small intestine, right colon, and pancreas. It gives off branches like the intestinal, ileocolic, right colic, and middle colic arteries. The inferior mesenteric artery supplies the hindgut, including parts of the left colon, sigmoid colon, and rectum. Its branches include the left colic, sigmoid, and superior rectal arteries.
The testis is the male gonad located in the scrotum. It has two poles, two borders, and two surfaces. The testis is covered by three layers: the tunica vaginalis, tunica albuginea, and tunica vasculosa. Internally, the testis contains 200-300 lobules with seminiferous tubules that produce sperm. The testis receives blood supply from the abdominal aorta and drains into veins that lead to the inferior vena cava or left renal vein. Lymphatic drainage is to the pre-aortic and para-aortic lymph nodes. The testis has both sensory and motor nerve supply. Abnormalities can
1. MRI is the preferred imaging modality for local staging of rectal cancer, allowing assessment of tumor stage, depth of invasion, and relationship to surrounding structures.
2. A high-quality MRI with thin slices and a small field of view is needed to accurately evaluate the tumor, lymph nodes, and circumferential resection margin.
3. Key findings on MRI include tumor distance to the mesorectal fascia, involvement of surrounding organs, and presence of extramural vascular invasion, which have prognostic significance.
This document discusses gastric carcinoma and gastric lymphoma. It begins with the epidemiology, risk factors, and routes of spread of gastric cancer. It then describes various radiological procedures used to image gastric carcinoma such as CT, MRI, PET, and barium studies. It discusses the radiographic and CT findings of early and advanced gastric cancers, including Borrmann classification correlated with CT findings. Lymph node metastasis and TNM staging criteria are also covered.
This document discusses abdominal aortic aneurysms (AAAs). It notes that Albert Einstein died from an AAA, which affects over 700,000 people in Europe. AAAs are a silent killer as they often show no symptoms. The main risk factors are being male, smoking history, hypertension, family history, and increasing age. Ultrasound is an effective way to diagnose AAAs. If left untreated, AAAs over 5cm have a high risk of rupture. Small AAAs under 4cm should be monitored annually, while larger AAAs may require surgical or endovascular treatment.
Summary and illustrations of various traumatic brain injury including primary and secondary lesions as well as limited information on indications of brain imaging in trauma
This document discusses various cardiac imaging techniques including plain x-rays, echocardiography, CT scans, MRI, and their use in evaluating heart conditions. Plain x-rays can provide information on cardiac size and structure while echocardiography uses ultrasound to examine cardiac anatomy, physiology, and flow velocities. CT scans detect atherosclerosis and other conditions while MRI is useful for assessing velocity, output, tumors, and shunts. These imaging tools help evaluate cardiomegaly, enlargement, vascular patterns, congenital heart diseases, and cardiac tumors.
The document provides detailed information about the anatomy and physiology of the brain and head. It describes the three main parts of the brain - the cerebrum, cerebellum and brain stem. It discusses the lobes of the cerebrum and various deep brain structures. The document then covers the skull, use of CT scanning to image the brain, the CT scanning procedure, common pathologies visible on brain CT scans, and provides examples of labeled brain CT images.
- Four densities are seen on chest X-rays: black for air/gas, dark grey for fat, light grey for fluid/solid organs, and white for bone/calcium.
- When reviewing chest X-rays, radiologists follow a systematic approach examining the lungs for opacities, the heart and vessels, under the diaphragm, and the extremities.
- Common findings include infiltrates, masses, pleural effusions, cardiomegaly, pulmonary edema, and fractures. Changes must be interpreted in the context of the patient's history and risk factors.
This document provides information on the ventricular system of the brain. It describes the lateral ventricles, third ventricle, cerebral aqueduct, and fourth ventricle. It discusses the relations, choroid plexuses, and radiological appearance of each part of the ventricular system. Radiological features on plain X-rays, CT, and MRI are also summarized.
The document provides detailed anatomical information about the sellar and suprasellar region. It describes the structures of the sphenoid bone, sphenoid sinus, diaphragma sellae, pituitary gland, cavernous sinus and their relationships. It also discusses the anatomy of the third ventricle and surrounding structures important for pituitary adenoma surgery, including cranial nerves, blood vessels and cisterns. Common tumors of the sellar region are also listed, along with surgical techniques for tumor removal such as transphenoidal hypophysectomy, transcranial hypophysectomy and computer-assisted surgery.
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
This document provides an overview of brain tumors, with a focus on glial tumors (gliomas). It discusses the different cell types that can give rise to gliomas and common glioma subtypes, including their incidence, associations, classifications, and radiographic features. In particular, it describes astrocytomas in depth, noting they represent 80% of gliomas. Key glioma subtypes addressed include low-grade astrocytomas, anaplastic astrocytomas, glioblastoma multiforme, brain stem gliomas, and other less common astrocytoma variants. Diagnostic imaging findings for each glioma subtype are emphasized.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.Abdellah Nazeer
This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
The document summarizes Couinaud's classification of liver segmental anatomy. It divides the liver into eight functionally independent segments, each with its own vascular inflow and outflow and biliary drainage. The right hepatic vein divides the right lobe into anterior and posterior segments. The middle hepatic vein divides the liver into right and left lobes. The left hepatic vein divides the left lobe into medial and lateral segments. The portal vein divides the liver into upper and lower segments.
The document summarizes the anatomy and contents of various brain cisterns. It describes the locations and structures contained within several major cisterns, including:
1) The cisterna magna, which contains the cerebellar medullary veins and lower cranial nerves.
2) The interpeduncular cistern, which is divided by membranes and contains the basilar artery, posterior cerebral arteries, and cranial nerves 3 and 6.
3) The ambient cistern, which surrounds the midbrain and contains the posterior cerebral artery and cranial nerve 4.
4) The suprasellar/chiasmatic cistern, located above the pituitary fossa,
Superior vena cava syndrome is caused by obstruction of blood flow through the superior vena cava, which drains blood from the upper half of the body. The most common causes are lung cancer and lymphoma. Symptoms include swelling of the face, neck and arms, cough, difficulty breathing. Diagnosis involves imaging tests and biopsy. Treatment depends on severity and cause, and may include supportive care, stents, chemotherapy, radiation therapy or surgery. Endovascular stents provide rapid symptom relief in many cases.
Radiographic Presentation of Congenital Heart DiseaseTarique Ajij
1. The document discusses the radiographic presentation of various congenital heart diseases including atrial septal defects, ventricular septal defects, patent ductus arteriosus, atrioventricular septal defects, pulmonic stenosis, aortic stenosis, coarctation of the aorta, tetralogy of Fallot, Ebstein's anomaly, transposition of the great arteries, truncus arteriosus, and total anomalous pulmonary venous connection.
2. Key findings on chest x-rays are described such as enlargement of specific heart chambers, changes in pulmonary vascularity, positioning of the great vessels, and rib notching.
3. Diagnosis is made through precordial examination, echocard
Benign breast diseases include conditions like fibrocystic disease, fibroadenomas, and breast cysts. Fibrocystic disease involves fibrosis, cyst formation, and breast pain or lumps and is caused by aberrations in normal hormonal cycles. Fibroadenomas are benign solid tumors composed of epithelial and stromal elements that can be solitary or multiple. Breast cysts are fluid filled sacs formed from lobular involution and cyst formation, and can be simple or complex. Clinical exam, imaging like mammography and ultrasound, and biopsy are used in evaluation and diagnosis of benign breast conditions.
This document provides information on the embryology, anatomy, histology, blood supply, lymphatic drainage and types of breast cancer. It begins with the embryological development of the breast from mammary ridges. It then describes the anatomy of the breast including its location, layers of tissue, blood and lymphatic drainage pathways. The histology section outlines the different cell types found in breast tissue. Finally, it discusses the different forms of breast cancer including non-invasive (DCIS, LCIS) and invasive types (ductal carcinoma, lobular carcinoma, medullary carcinoma).
The testis is the male gonad located in the scrotum. It has two poles, two borders, and two surfaces. The testis is covered by three layers: the tunica vaginalis, tunica albuginea, and tunica vasculosa. Internally, the testis contains 200-300 lobules with seminiferous tubules that produce sperm. The testis receives blood supply from the abdominal aorta and drains into veins that lead to the inferior vena cava or left renal vein. Lymphatic drainage is to the pre-aortic and para-aortic lymph nodes. The testis has both sensory and motor nerve supply. Abnormalities can
1. MRI is the preferred imaging modality for local staging of rectal cancer, allowing assessment of tumor stage, depth of invasion, and relationship to surrounding structures.
2. A high-quality MRI with thin slices and a small field of view is needed to accurately evaluate the tumor, lymph nodes, and circumferential resection margin.
3. Key findings on MRI include tumor distance to the mesorectal fascia, involvement of surrounding organs, and presence of extramural vascular invasion, which have prognostic significance.
This document discusses gastric carcinoma and gastric lymphoma. It begins with the epidemiology, risk factors, and routes of spread of gastric cancer. It then describes various radiological procedures used to image gastric carcinoma such as CT, MRI, PET, and barium studies. It discusses the radiographic and CT findings of early and advanced gastric cancers, including Borrmann classification correlated with CT findings. Lymph node metastasis and TNM staging criteria are also covered.
This document discusses abdominal aortic aneurysms (AAAs). It notes that Albert Einstein died from an AAA, which affects over 700,000 people in Europe. AAAs are a silent killer as they often show no symptoms. The main risk factors are being male, smoking history, hypertension, family history, and increasing age. Ultrasound is an effective way to diagnose AAAs. If left untreated, AAAs over 5cm have a high risk of rupture. Small AAAs under 4cm should be monitored annually, while larger AAAs may require surgical or endovascular treatment.
Summary and illustrations of various traumatic brain injury including primary and secondary lesions as well as limited information on indications of brain imaging in trauma
This document discusses various cardiac imaging techniques including plain x-rays, echocardiography, CT scans, MRI, and their use in evaluating heart conditions. Plain x-rays can provide information on cardiac size and structure while echocardiography uses ultrasound to examine cardiac anatomy, physiology, and flow velocities. CT scans detect atherosclerosis and other conditions while MRI is useful for assessing velocity, output, tumors, and shunts. These imaging tools help evaluate cardiomegaly, enlargement, vascular patterns, congenital heart diseases, and cardiac tumors.
The document provides detailed information about the anatomy and physiology of the brain and head. It describes the three main parts of the brain - the cerebrum, cerebellum and brain stem. It discusses the lobes of the cerebrum and various deep brain structures. The document then covers the skull, use of CT scanning to image the brain, the CT scanning procedure, common pathologies visible on brain CT scans, and provides examples of labeled brain CT images.
- Four densities are seen on chest X-rays: black for air/gas, dark grey for fat, light grey for fluid/solid organs, and white for bone/calcium.
- When reviewing chest X-rays, radiologists follow a systematic approach examining the lungs for opacities, the heart and vessels, under the diaphragm, and the extremities.
- Common findings include infiltrates, masses, pleural effusions, cardiomegaly, pulmonary edema, and fractures. Changes must be interpreted in the context of the patient's history and risk factors.
This document provides information on the ventricular system of the brain. It describes the lateral ventricles, third ventricle, cerebral aqueduct, and fourth ventricle. It discusses the relations, choroid plexuses, and radiological appearance of each part of the ventricular system. Radiological features on plain X-rays, CT, and MRI are also summarized.
The document provides detailed anatomical information about the sellar and suprasellar region. It describes the structures of the sphenoid bone, sphenoid sinus, diaphragma sellae, pituitary gland, cavernous sinus and their relationships. It also discusses the anatomy of the third ventricle and surrounding structures important for pituitary adenoma surgery, including cranial nerves, blood vessels and cisterns. Common tumors of the sellar region are also listed, along with surgical techniques for tumor removal such as transphenoidal hypophysectomy, transcranial hypophysectomy and computer-assisted surgery.
This document discusses fetal neurosonography and the sonographic appearance of fetal brain structures throughout gestation. It begins with an overview of embryonic brain development and the division of the brain into sections. It then examines how the appearance of specific structures changes with gestational age, including the posterior fossa, lateral ventricles, and cerebellum. Serial images demonstrate the maturation and relationships between structures over time. The role of 3D imaging in examining the posterior fossa is also mentioned.
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
This document provides an overview of brain tumors, with a focus on glial tumors (gliomas). It discusses the different cell types that can give rise to gliomas and common glioma subtypes, including their incidence, associations, classifications, and radiographic features. In particular, it describes astrocytomas in depth, noting they represent 80% of gliomas. Key glioma subtypes addressed include low-grade astrocytomas, anaplastic astrocytomas, glioblastoma multiforme, brain stem gliomas, and other less common astrocytoma variants. Diagnostic imaging findings for each glioma subtype are emphasized.
Presentation1.pptx, ultrasound examination of the 2nd & 3rd trimester pregnancy.Abdellah Nazeer
This document provides guidance on performing an ultrasound examination of the fetus in the second and third trimesters of pregnancy. It details the standard views and measurements that should be obtained, including images of the head, heart, abdomen, limbs and other structures. Potential abnormalities are also listed for each structure. Fetal echocardiography is important for detecting congenital cardiac defects, which occur in 2-6.5% of live births and can have serious consequences if not identified prenatally.
The document summarizes Couinaud's classification of liver segmental anatomy. It divides the liver into eight functionally independent segments, each with its own vascular inflow and outflow and biliary drainage. The right hepatic vein divides the right lobe into anterior and posterior segments. The middle hepatic vein divides the liver into right and left lobes. The left hepatic vein divides the left lobe into medial and lateral segments. The portal vein divides the liver into upper and lower segments.
The document summarizes the anatomy and contents of various brain cisterns. It describes the locations and structures contained within several major cisterns, including:
1) The cisterna magna, which contains the cerebellar medullary veins and lower cranial nerves.
2) The interpeduncular cistern, which is divided by membranes and contains the basilar artery, posterior cerebral arteries, and cranial nerves 3 and 6.
3) The ambient cistern, which surrounds the midbrain and contains the posterior cerebral artery and cranial nerve 4.
4) The suprasellar/chiasmatic cistern, located above the pituitary fossa,
Superior vena cava syndrome is caused by obstruction of blood flow through the superior vena cava, which drains blood from the upper half of the body. The most common causes are lung cancer and lymphoma. Symptoms include swelling of the face, neck and arms, cough, difficulty breathing. Diagnosis involves imaging tests and biopsy. Treatment depends on severity and cause, and may include supportive care, stents, chemotherapy, radiation therapy or surgery. Endovascular stents provide rapid symptom relief in many cases.
Radiographic Presentation of Congenital Heart DiseaseTarique Ajij
1. The document discusses the radiographic presentation of various congenital heart diseases including atrial septal defects, ventricular septal defects, patent ductus arteriosus, atrioventricular septal defects, pulmonic stenosis, aortic stenosis, coarctation of the aorta, tetralogy of Fallot, Ebstein's anomaly, transposition of the great arteries, truncus arteriosus, and total anomalous pulmonary venous connection.
2. Key findings on chest x-rays are described such as enlargement of specific heart chambers, changes in pulmonary vascularity, positioning of the great vessels, and rib notching.
3. Diagnosis is made through precordial examination, echocard
Benign breast diseases include conditions like fibrocystic disease, fibroadenomas, and breast cysts. Fibrocystic disease involves fibrosis, cyst formation, and breast pain or lumps and is caused by aberrations in normal hormonal cycles. Fibroadenomas are benign solid tumors composed of epithelial and stromal elements that can be solitary or multiple. Breast cysts are fluid filled sacs formed from lobular involution and cyst formation, and can be simple or complex. Clinical exam, imaging like mammography and ultrasound, and biopsy are used in evaluation and diagnosis of benign breast conditions.
This document provides information on the embryology, anatomy, histology, blood supply, lymphatic drainage and types of breast cancer. It begins with the embryological development of the breast from mammary ridges. It then describes the anatomy of the breast including its location, layers of tissue, blood and lymphatic drainage pathways. The histology section outlines the different cell types found in breast tissue. Finally, it discusses the different forms of breast cancer including non-invasive (DCIS, LCIS) and invasive types (ductal carcinoma, lobular carcinoma, medullary carcinoma).
This document summarizes a lecture on the mammary gland given by Dr. Abdul Waheed Ansari. The lecture covers the gross anatomy, histology, development, and clinical importance of the breast. Specific learning outcomes include identifying the location and structure of the breast, distinguishing normal breast histology, analyzing lymphatic drainage, correlating development, and interpreting mammograms. The lecture discusses the location, blood supply, lymphatic drainage, development, histology of lactating and non-lactating breasts, and clinical significance including metastasis routes. Key clinical points are made about skin dimpling, cancer spread routes, and abnormal mammogram findings.
The document provides information about the anatomy of the female breast/mammary gland, including its shape, position, structure, blood and lymphatic supply, and applied clinical relevance. It discusses the following key points:
- The breast is conical in shape and extends from the 2nd to 6th ribs laterally to the midaxillary line. Its base lies primarily on the pectoralis major muscle.
- It has 15-20 lobes formed by lobules drained by lactiferous ducts opening at the nipple. It is supported by fibrous ligaments and has a blood supply from perforating branches of the internal thoracic artery.
- Lymphatic drainage is primarily to the ax
1. The mammary gland lies in the superficial fascia of the chest wall and extends from the 2nd to 6th ribs and from the sternum to the midaxillary line.
2. It has no capsule and is made up of glandular, fibrous and fatty tissue arranged in lobes that are drained by lactiferous ducts opening onto the nipple.
3. The mammary gland receives its blood supply from perforating branches of the internal thoracic arteries and the lateral thoracic artery, and drains into axillary, internal thoracic and intercostal veins.
lecture 5b The breast and pectoral region.pdfNatungaRonald1
The breast lies in the pectoral region and develops during puberty under the influence of female sex hormones. It is composed of lobules that radiate from the nipple. The breast undergoes changes during pregnancy and menopause. Cancer is a major health concern and can spread via the lymphatic drainage pathways.
The pectoral region contains muscles that act on the arm including the pectoralis major and minor. The serratus anterior muscle rotates the scapula. All three muscles receive nerve innervation from branches of the brachial plexus. Knowledge of the anatomical structures of the breast and pectoral region is important for clinical diagnosis and management.
1) The breast is composed of adipose tissue, lactiferous ducts and tubules, blood vessels, nerves and lymphatics. It extends from the 2nd to 6th ribs and medially from the lateral border of the sternum to the mid-axillary line.
2) The breast parenchyma contains 15-20 lobes made up of lobules that empty into lactiferous ducts. It also contains stromal connective and fatty tissue.
3) Lymphatic drainage of the breast primarily follows the blood supply to the axillary lymph nodes but may also drain to internal mammary or intercostal nodes. Sentinel lymph node biopsy is used to help determine cancer stage
This document provides information about the anatomy of the female breast (mammary gland). It describes the shape and position of the breast as conical and extending from the 2nd to 6th ribs laterally to the midaxillary line. It details the structure of the breast as having 15-20 lobes made up of lobules drained by 15-20 lactiferous ducts opening at the nipple. It discusses the blood supply from perforating branches of the internal thoracic artery and lateral thoracic artery. It outlines the lymphatic drainage from subareolar and deep plexuses into axillary lymph nodes arranged into 5 groups. It covers applied anatomy regarding breast cancer occurrence in the upper lateral quadrant and drainage to axillary nodes
The document discusses the anatomy and physiology of mammary glands. It begins by defining mammary glands as breasts in medical terminology, originating from the Latin word for breasts. It then describes the basic structure of mammary glands, which consist of skin, parenchyma (lobes and ducts), and stroma (connective tissue). The document outlines the development of mammary glands from an embryonic ridge, and their histology in non-pregnant, pregnant, and lactating states. It also reviews the blood supply, lymphatic drainage, and clinical aspects such as breast cancer.
breast is the mammary gland with lobes and ductules with lactiferous ducts.
it extends from 2nd intercostal to 6 intercostal ribs and lies over pectoralis major muscle
Lecture 5- FEMALE BREAST ANATOMY FOR NURSING STUDENT 2-1.pptprincessufookoye
Female breast anatomy for nursing students. Female breast anatomy for nursing students. Female breast anatomy for nursing students. Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nursing students Female breast anatomy for nurs
The document provides information about the female breast (mammary gland), including its:
- Shape (conical), position (extending from the 2nd to 6th ribs), and parts (base, apex, tail).
- Internal structure of lobes, lobules, and lactiferous ducts.
- Blood supply from perforating branches of the internal thoracic and lateral thoracic arteries.
- Lymphatic drainage into axillary lymph nodes arranged into groups.
- Clinical relevance including cancer detection via sentinel node biopsy and risk of lymphedema after node removal.
This document describes the anatomy of the breast. It discusses the location and extensions of the breast, its structure including the parenchyma, stroma and blood supply. It also outlines the lymphatic drainage pathways from the breast which are mainly to the axillary nodes but also to internal mammary and intercostal nodes. Surgical approaches and lymph node levels related to breast surgery are defined.
The document provides an overview of the breast and pectoral region. It discusses the structure, development, blood supply and lymphatic drainage of the breast. It also outlines the muscles of the pectoral region including the pectoralis major and minor, serratus anterior, and subclavius. The presentation additionally covers cancer of the breast including causes, signs, diagnosis and management.
This document provides an overview of evaluating and managing a breast lump. It discusses the anatomy of the breast and describes the triple assessment approach including clinical examination, imaging studies, and biopsy. Common benign and malignant breast conditions are outlined. Fine needle aspiration, core needle biopsy, and excisional biopsy techniques are also summarized. The document reviews breast cancer staging and provides examples of evaluating specific breast lumps.
FEMALE Breast anatomy ffffffffffffffffffffffffffffElgilanizaher
The female breast is conical in shape and lies in the superficial fascia of the chest. It has a base, apex, and tail, with its base extending from the 2nd to 6th ribs and across from the sternum to the midaxillary line. The nipple is a conical projection from the breast that lies at the 4th intercostal space, carrying 15-20 pores of lactiferous ducts. The areola is a dark pink area surrounding the nipple. The breast tissue is made up of 15-20 lobes and lobules embedded in fat and separated by Cooper's ligaments. Lymphatic drainage is primarily to the axillary lymph nodes, with some drainage to internal thoracic
Lymphatic Drainage Of Breast and Its AppliedAayush Rai
This document provides an overview of the breast anatomy and lymphatic drainage. It discusses:
- The location, structure, and extent of the breast and mammary gland.
- The lymphatic vessels and lymph nodes that drain the breast, particularly the axillary lymph nodes.
- How breast cancer can spread through the lymphatic system to other lymph nodes in the axilla, internal mammary nodes, and further in the body.
- Special points about lymphatic drainage patterns and the concept of sentinel lymph nodes for biopsy.
The document provides an overview of the breast anatomy and lymphatic drainage. It discusses:
- The breast's location, extent, and lymphatic system. Lymph flows primarily to axillary nodes but also to internal mammary and intercostal nodes.
- Sentinel lymph nodes are the first nodes draining a cancer, important for sentinel lymph node biopsy.
- The upper outer breast quadrant contains most glandular tissue and most cancers originate here.
- Lymphatic obstruction by cancer can cause lymphedema, peau d'orange skin, and nipple retraction. Mammography is used to detect breast masses.
This document discusses various clinical trials related to stomach cancer treatment. It summarizes that:
1) The D2 dissection surgery showed better local control and reduced gastric cancer deaths compared to D1 dissection.
2) Perioperative chemotherapy was found to be better than surgery alone in reducing tumor size and death rates based on the MAGIC trial.
3) The FLOT regimen showed improved survival over ECF/ECX as perioperative chemotherapy in locally advanced gastric cancer.
4) Postoperative chemotherapy provides a survival benefit compared to surgery alone based on meta-analysis results. The CLASSIC trial also showed improved outcomes with adjuvant capecitabine and oxaliplatin.
Three clinical trials comparing different treatments for oropharynx and larynx cancer were summarized:
1. RTOG 9003 found that hyperfractionated RT showed significantly improved OS and LRC compared to standard fractionation for advanced cancers. Acute toxicities were similar between arms.
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1) A cell survival curve shows the relationship between the proportion of cells surviving and the radiation dose or dose of a cell-killing agent. It is used to assess the biological effectiveness of radiation.
2) Radiation can kill cells through direct damage, free radical injury, apoptosis, mitotic death, bystander effects, autophagy, and senescence. The mechanism of cell death influences whether the survival curve is linear or has a shoulder.
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Hyperthermia involves heating tumor tissue above normal body temperature to damage and kill cancer cells. It has been used experimentally for thousands of years to treat tumors. Effects are due to protein damage within cells. Hyperthermia can enhance the effects of radiation therapy by making tumor cells more sensitive. Temperature and exposure time determine cell death in a predictable way. Factors like pH, oxygen levels, and cell cycle stage influence response. Temperature is monitored and thermal dose is calculated to determine treatment effectiveness. Hyperthermia shows promise for improving cancer treatments when combined with other therapies.
The document discusses the anatomy, histology, staging, and workup of esophageal cancer. It describes the esophagus as a hollow muscular tube connecting the pharynx to the stomach. Esophageal cancer most often presents with dysphagia and can spread through lymphatic channels or directly invade nearby structures. Staging involves endoscopy, endoscopic ultrasound, CT, and PET scans to determine the depth of invasion and presence of metastases.
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3. EMBRYOLOGY
STARTS FROM 4TH WEEK OF INTRA
UTERINE LIFE
MAMMARY RIDGE > MAMMARY PIT>
SECONDARY BUDS (LOBES)
GLAND FROM ENDODERM
STROMA FROM MESODERM
NIPPLE DEVELOP AT THE PLACE OF
MAMMARY RIDGE
5. BREAST
MODIFIED SWEAT GLAND
NO SPECIAL CAPSULE OR SHEATH
PRESENT IN BOTH SEX
IN ANIMALS ,GENUS MAMMALS IS MARKED BY
THE PRESENCE OF THESE GLANDS
SECONDARY SEX ORGAN
ORGAN OF LACTATION
6. DIVISION
• BREAST IS DIVIDED INTO 5 QUADRANTS FOR EASY AND
UNIFORM REPORTINGOF LUMP LOCATION
• THE BREAST EXTENDS TOWARDS AXILLA AND CALLED TAIl
OF SPENCE
• IN SOME PEOPLE IT IS USUALLY PALPABLE , IN SOME
DURING PREMENSTRUAL PHASE AND LACTATION
• hence the upper outer quadrant has more tissue than others and
so greater incidence of cancer (38.5%)
• CENTRAL AREA 29% UIQ 14.2% LOQ 8.5% LIQ5%
• there is a pattern of drainage from each quadrant, for eg. upper
outer quadrant more to axillary nodes
7. GROSS ANATOMY
• EXTENSION
• 2nd rib to 6/7 th rib
• lateral border of sternum
• mid axillary line
• MAY ALSO EXTEND
• clavicle to 8th rib
• midline
• upto lattismus dorsi
significance ; during mastectomy
whole breast has to be removed
8. BREAST BED
• medially 2/3 rd by pectoral fascia overlying
pectoralis major
– between investing breast fascia and
pectoral fascia there is aspace
containing loose areolar tissue ,due to
this the breast is mobile over P.M
muscle.in optimally taken
mammography this space is visible
• rest by fascia over serratus anterior
• inferiorly external oblique aponeurosis
• for staging chest wall is formed by
serratus anterior , ribs and intercostal
muscles (perez)
9.
10. WITHIN
• GLAND PARENCHYMA :
– NIPPLE > LACTIFEROUS SINUS > DUCT > LOBE >
EXTRA LOBULAR TERMINAL DUCT > LOBULE >
INTRA LOBULAR TERMINAL DUCT > ACINI
– during pregnancy the acini will proliferate and lobule
becomes store house of milk , stroma will be less
• STROMA :
– INTERINTERLOBULAR & INTRA LOBULAR
• TDLU - TERMINAL DUCTAL LOBULAR UNIT functional
unit of breast with 30 -50 acini (1-4 mm) ,
• Origin of cancer - TDLU
11. NIPPLE AND AREOLA
• Nipple where then lactiferous duct ends
and milk is ejected out and
circumferential skin sdevoid of fat, hair
and sweat glands the areola, contains
smooth muscle arranged concentrically
thus erectile in nature.
• retraction of nipple :
– congenital - can be everted
– acquired ( cannot br everted )
– slit like - duct ectasia
– circumferential - carcinoma infilterating
ducts
– hence in carcinoma nipple areolar
complex is distorted
– it is not considered as skin involvement
12. discharge from nipple
• milk - lactation , new born
babies ( physiological),
prolactinemia pituatory
adenoma, bronchogenic
ca
• green - duct ectasia
• bloody - carcinoma,
• pus- mastits, abscess
13. coopers ligament
• condensed fibrous
connective tissue attached
from superficialascia to
dermis of skin overlying
breast
• supportive structure
• infilteration of skin by
carcinoma causes
dimpling/puckering of skin
• it is not considered as
skin involvement in staging
14. ARTERIAL
SUPPLY
• subclavian artery > internal
thoracic artery
• axillary artery> lateral thoracic
, superior thoracic , acromio
thoracic
• posterior interscostal artery
lateral branch
• anterior part of breast
receives more blood supply
and posterior part relatively
avascular
15. VENOUS
DRAINAGE
• superficial veins - internal
thoracic vein, superficial
veins in lower part of neck
• deep veins - axillary and
posterior intercostal veins
16. en route spine -THE BATSON’S
PLEXUS
• a network of valveless veins in the human body
that connects the deep pelvic vein and thoracic
veins to internal vertebral venous plexus
• invests the vertebra and extends from base of
skull to sacrum
• posterior intercostal veins> azygous
/hemiazygous veins along side the body of
vertebrae > batson vertebral venous plexus >
internal vertebral venous plexus surrounding the
spinal scord
20. IC
DRAINAG
E
• NIPPLE AREOLA
&LOBULES , INTER
LOBULAR
CONNECTIVE
TISSUE >
SUBAREOLAR
LYMPHATIC PLEXUS
> NODES
• SKIN (EXCLUDING
NIPPLE AND AREOLA
) > AXILLARY AND
21.
22. PEAU D’ ORANGE
• Due to blockage of
subareolar lymphatic
plexus by metastatic cells
(lymphedema)
• In turn causes deviation of
nipple and thickened
leather-like appearance of
skin
• Prominent or puffy skin
between dimpled pores →
orange peel appearance
23. LEVEL WITH
RESPECT TO
PECTORALIS
MINOR BERG”S
GROUP AXILLARY FOSSA RELATION TO ADJACENT
STRUCTURE
NUMBER OF
NODES
Level I Lymph
nodes (lateral or
below the lower
border of Pectoralis
minor
Axillary vein group
(Humeral group)
lateral Medial or posterior to axillary
vein
4-6
External mammary
group
anterior or pectoral Along lower border of pectoralis
minor Contiguous with lateral
thoracic vessels
5-6
Scapular group posterior or
subscapular
Along posterior wall axilla at
lateral border of scapula
Contiguous with subscapular
vessels
5-7
Level II Lymph
nodes (superficial
or deep to
pectoralis minor)
Central group central Embedded in fat
Immediately posterior to
pectoralis minor
3-4 sets
interpectoral group
(rotters node)
Interposed between pectoralis
major and pectoralis minor
1-4
Level III Lymph
nodes (medial or
above the upper
border of pectoralis
minor
Subclavicular group apical Posterior and superior to upper
border of pectoralis minor
6-12 sets
24. INTERNAL MAMMARY
NODE
Lymph vessels that accompany the perforating
branches of internal mammary artery enters
into para sternal (internal mammary) nodes
Lie along the int.mam vessels, deep to the
plane of costal cartilage
Not routinely dissected although once they
were biopsied for staging
Drains into broncho mediastinal trunk
25.
26. PATHWAY OF
SPREAD
• Diagrammatic representation of lymphatic drainage (single
line) and blood spread (double line) in carcinoma of the breast.
• Lymphatic drainage from the subareolar plexus of Sappey and
outer quadrant of the breast takes place first to the pectoral (P),
then central (C) and lastly to the apical (A) group of axillary
lymph nodes.
• The other two groups of the axillary nodes, viz. the subscapular
and lateral group may be involved in a retrograde way. From
the apical group the supraclavicular group may be affected.
• On the left side the supraclavicular group is affected by
retrograde permeation.
• The upper quadrant of the breast drains partly to the delto-
pectoral node but mainly to the apical group. From the inner
quadrant the lymph spread occurs to the internal mammary
group (In. M) and to the other breast (Br).
27. • From the lower and inner
parts of the breast the lymph
vessels form a plexus over
the rectus sheath and pierce
the costal margin to
communicate with the
subperitoneal lymph plexus.
• From this place, cancer cells
may drop by gravity into the
pelvis (Transcoelomic
implantation) and may cause
metastases in the ovary
(Krukenberg's tumour).
• It may be noted that the liver
may be involved in two ways
subperitoneal plexus and by
blood spread.
• Blood spread - occurs in
34. DCIS
It is confined to the ductal system of the breast
It lacks the histologic evidence of invasion
From low grade non –comedo DCIS to high grade comedo DCIS
• Comedo
• Solid
• Cribriform
• Micropapillary
• Papillary
Based on the architectural or morphological appearance:
36. Growth pattern
Unicentric – one area only
Multicentric – two different areas separated by >4cm
Continuous - extension along ductal systems without gap
Multifocal/ discontinuous - two or more areas separated by <4cm
37. LCIS
• It is a benign entity
• Loose discohesive epithelial
cells that are large in size
,variable in shape and normal
cytoplasm to nuclear ratio.
• ER –positive
• Loss of e-cadherin
• Represents <15% of all non-
invasive breast ca
38. PAGETS DISEASE
CRUSTING AND ECZEMATOUS CHANGES OF
NIPPLE AND AREOLAR COMPLEX
PRESENCE OF PAGETS CELLS THROUGHT
THE EPIDERMIS
MOSTLY ASSOCIATED WITH UNDERLYING
MALIGNANCY
SO COMPLETE EXAMINATION OF THE
BREAST IS IMPORTANT
ECZEMA IS B/L but PAGETS DISEASE IS U/L
39. INVASIVE LESIONS OF THE BREAST
• invasive carcinoma of no special type
• invasive carcinoma special types
– ductal
– tubular
– mucinous
– medullary
– inflammatory
– lobular
44. ER
• estrogen receptor gets
activated and leads to cell
proliferation
• ER is positive about 70%
breast ca
• er are mostly nuclear
receptor, and central part
of the cell gets stained
51. BREAST CANCER
• MOST COMMON CANCER among WOMEN
WORLDWIDE
• THE OLDEST EVIDENCE OF BREAST CANCER IS
4200 years ago IN EGYPT
• CAUSE OF BREAST CANCER – CUMULATIVE
EFFECT OF GENETIC, ENVIRONMENTAL,
HORMONAL, LIFESTYLE FACTORS
• SCREENING, MANAGEMENT IS EASILY AVAILABLE
AT NCD CENTRES FROM SUBCENTRE LEVEL TO
RCC
52. EPIDEMIOLOGY OF BREAST
CANCER
AGE
• incidence of breast cancer increases exponentially upto menopause , then slowly
, after 80 th rate slowly declines
Age at first child birth
• Mac mahon et all : linear relation between age at first child birth and incidence of
breast cancer
• Aged 20 – 25 at first child birth have 50% decreased risk than nulliparous women
• Breast feeding _ no sufficient data
SEX females > males
53. Ovarian function
• Long menstrual history ,
early menarche and late
menopause _ long
estrogen exposure
Exogenous hormone
• Increased RR of 1.35 for
current or recent users of
hormonal replacement
• Post menopausal hormone
therapy RR increase by
2.3% foe each year
The use of oral contraceptive
pill has not been consistently
shown to increase the risk of
breast can cancer
54. • Family history
– 1st degree relative (mother or sister) risk is 1.7 to 2.5
– 2nd degree relative (grand ma or aunt ) risk is 1.5
• Due to mutation In BRCA 1 , BRCA 2 , shared life style , inheritance of genes for other risk
factors ( body habitus , age at menarche)
• Although mutation is present in 1% of population and approx. 5 to 10%breast cancer cases
, women with mutation carry lifetime risk of 70% to 80% .
55. NCCN guidelines for genetic testing
1. The individual has a family history of a known BRCA1/BRCA2 mutation
2. Personal history of breast cancer plus one of the following:
a. Diagnosed age 45 years or younger
b. Diagnosed age ≤50 years with one or more close blood relatives with breast cancer at
any age, one or more close blood relatives with pancreatic cancer, one or more close
blood relatives with prostate cancer, or an unknown or limited family history. Diagnosed
age ≤60 years with a triple negative (TN) breast cancer. Diagnosed at any age with two
or more close blood relatives with breast, pancreatic, or prostate cancer at any age, ≥1
close blood relative with breast cancer ≥50 years, ≥1 close blood relative with ovarian
cancer, close male blood relative with breast cancer or an individual of ethnicity
associated with higher mutation frequency (e.g., Ashkenazi Jewish). Personal history of
epithelial ovarian/fallopian tube/primary peritoneal cancer, or
c. c. Personal history of male breast cancer
56. • Personal history of breast cancer and history of benign breast biopsy
– Patients treated for invasive breast cancer or DCIS have similar risks of
developing a contralateral breast cancer, which does not appear to be
effected by the type of local therapy for the initial lesion
– recent analysis of the SEER database demonstrated that 4.2% of localized
invasive or intraductal breast cancer patients surviving at least 3 months
developed contralateral breast cancer with the 10- and 20-year actuarial rate
of CBC being 6.1% and 12% .
57. • Prior radiation exposure
– Land et al.26,27 reviewed reports on three populations of
patients exposed to ionizing radiation by atomic bombings,
multiple fluoroscopic examinations for tuberculosis, and
multiple examinations for mastitis. They concluded that the risk
of radiation-induced cancer of the breast increased
approximately linearly with increasing dose and was heavily
dependent on age at exposure.
– 28 A high risk of solid tumors, especially breast cancer, has
been described in
women treated with RT at a young age for Hodgkin lymphoma
58. • BMI
– The higher risk of breast cancer with
increased BMI in postmenopausal
women is likely due to higher
estradiol levels associated with
increased adipose tissue and
increased aromatase, which is
involved in the conversion of
androgens to estradiol
59. • Physical activity and diet
– A majority of studies, however, have observed a lower risk of
breast cancer among women who are more physically active
compared with women who are sedentary
– large prospective studies have failed to demonstrate an
association between dietary fiber intake and breast cancer risk.
• Assessing the individuals risk
– In the Gail model, an individual’s annual risk of breast cancer is
based on her present age, number of first-degree relatives with
breast cancer, age at first birth, age at menarche, number of
breast biopsies, and history of atypical ductal hyperplasia. The
use of exogenous hormones is not considered in this model,
and many of the other risk factors discussed above are not
60. GENETIC MUTATION
• All forms of breast cancer are believed to develop as a
consequence of
unregulated growth, and development of phenotypic
changes – ability to invade , angiogenesis, metastasize
• These changes in phenotypes are secondary to aberrations in
genetic pathways
– Few aberrations are inherited( germ line mutation)
– Others develop during the life of breast cell ( somatic mutation)
61. Germline muation
1. the p53 tumor suppressor gene – guardian of genome
, direct response to DNA injury
2. Muation – childhood sarcoma, gynaec ca, breast ca
3. Li – Fraumeni syndrome – 90% life time risk of
developing breast ca
• BReast CAncer gene BRCA 1 and BRCA2 tumor
suppressor gene , mediating cellular response to DNA
injury
• Germline mutation inBRCA 1 and BRCA 2 are rare ,
62.
63. BRCA1
• CHROMOSOME 17
• Breast Cancer:
-Path: Often "Triple Negative" (ER/PR/Her2-),
- YOUNGER Age
Ovarian Cancer:
• - HIGHER Risk: up to -50-60% - YOUNGER Age of
onset
• Other Cancers:
• - Pancreas: -3-4%
• - Prostate: increased
• - Male Breast: increased
• - Colon??
– hboc
BRCA2
• CHROMOSOME 13
• Breast Cancer:
• -Path: Similar to Sporadic (ER/PR+, Her2-)
• -Slightly OLDER than BRCA1
• Ovarian Cancer:
• - LOWER Risk: up to -27% - OLDER Age (usually >
age 50)
• Other Cancers:
• - Pancreas: up to 10%
• - Prostate: HIGHER than BRCA1
• - Male Breast: 6-7%
• - Stomach, Gallbladder/Bile Duct,
• Melanoma
64.
65. The NCCN has published a guideline
recommending that individuals with a genetic
predisposition
• undergo breast awareness starting at age 18,
• annual clinical and self-breast examination starting at age 25,
• annual mammography or magnetic resonance imaging (MRI)
• semiannual clinical and self-breast examination after age 25.
• In addition, annual pelvic examinations with transvaginal sonography, color
Doppler examinations of the ovaries, and measurement of serum(CA- 125)
levels can be considered beginning at age 30 to 35 years.
• For those women aged 35 to 40, a risk-reducing bilateral salpingo-
oophorectomy is recommended, with possible short-term hormone
replacement therapy.
75. TAKE HOME MESSAGE
• Breast is present in both sex
• upper outer quadrant has more tissue than others and so
greater incidence of cancer (38.5%)
• for staging chest wall is formed by serratus anterior , ribs
and intercostal muscles (perez)
• Dimpling of skin, nipple retraction, peau d orange app are
not skin involvement
• TDLU - TERMINAL DUCTAL LOBULAR UNIT functional
unit of breast
• LCIS - is not included in TNM staging
• focality and centric is said using intervening normal tissue
not by the quadrant involved
76. • lymphatic drainage is IMN along
with ALN
• in cause - exogenous estrogen
;only the post menopausal
hormonal therapy but not the ocp
• hereditary cause of breast cancer is
only 5 to 10 % , somatic acquired
muation is more common
• it is the cumulative effect of many
factors that leads to cancer
• positive in cancer : ER - 70 % ,Her
2 - 15 to 20%
77. Reference
• ANATOMY
– BD CHAURASIA 6TH EDI
– NETTERS ATLAS 5TH EDI
• EMBRYOLOGY
– INDERBIR SINGH 1OTH EDI
• HISTOPATHOLOGY
– ROBBINS 9TH EDI
• EPIDEMILOGY
– PEREZ 7TH EDI
• IMAGING ANATOMY
– Radiopedia.com