The document discusses breast masses in adolescents. It notes that while uncommon, breast masses can cause significant distress for patients and families. The prevalence of breast masses in teenage girls is approximately 3.2%. Evaluation of breast masses in adolescents includes history, physical exam, ultrasound, and biopsy if needed. Common benign causes include fibroadenomas, cysts and abscesses. Rare malignancies can occur but make up only 0.02% of surgically removed breast masses in adolescents.
Presentation about the the second most common type of ovarian tumors which have a very unique property of being similar to the testicular germ cell tumors.
Presentation about the the second most common type of ovarian tumors which have a very unique property of being similar to the testicular germ cell tumors.
All the guidelines recommend co testing as the modality of choice for cervical cancer screening.
However, Cobas test was approved by FDA as primary screening modality in 2014.
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
All the guidelines recommend co testing as the modality of choice for cervical cancer screening.
However, Cobas test was approved by FDA as primary screening modality in 2014.
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Breast
Masses
• Uncommon
In
Children
And
Adolescents
• Associated
With
Significant
Pa:ent
And
Family
Distress
• The
Prevalence
Of
Breast
Masses
In
Teenage
Girls
Is
3.2%.
3. • Adolescent
Breast
Masses
Are
Typically
Benign
•
Although
Breast
Malignancies
Reported.
– Surgically
Removed
Breast
Masses
• 95%
Benign
Fibroadenomas
• Only
0.02%
Malignancies
4. Differen:al
Diagnosis
• Similar
To
Those
In
Adults
• Phyllodes
Tumors
• Primary
Breast
Cancer
• Sarcoma
• Lymphangioma
• Hemangioma
• Metasta:c
Cancer,
• Intraductal
Papilloma
• Fibroadenoma
(And
Giant
Fibroadenoma)
• Abscesses
• Benign
Cysts
5. • The
prevalence
of
breast
masses
among
teenage
girls
is
approximately
3.2
percent.
• Common
causes
include
fibroadenoma,
cysts,
hamartoma,
fat
necrosis,
or
abscess.
• Because
the
diagnosis
of
a
primary
breast
carcinoma
is
rare,
• the
differen:al
diagnosis
includes
rare
metasta:c
disease
from
malignant
tumors,
including
rhabdomyosarcoma,
lymphoma,
and
neuroblastoma
6. For
Evalua:on
Of
Any
Breast
Mass.
• History
And
Physical
Exam
are
essen:al
to
guiding
diagnosis.
• Careful
detail
pertaining
to
the
breast
mass,
• Pain
• Nipple
Discharge
• Precipita:ng
Factors
• Dura:on
And
Progression
• Ultrasound
provides
the
best
imaging
in
the
adolescent
age
group
and
is
an
essen:al
diagnos:c
tool.
7. For
Evalua:on
Of
Any
Breast
Mass.
• Fine
Needle
Aspira:on
(FNA)
• Excisional
Biopsy
• Magne:c
Resonance
Imaging
(MRI)
Provides
An
Imaging
Modality
Without
Radia:on
Exposure
To
Children,
But
Efficacy
And
Accuracy
Of
MRI
Breast
Evalua:on
In
Children
Has
Not
Yet
Been
Validated.
8.
Sebaceous
Cyst
• An
Epidermal
Cyst
• Classic
Feature
Of
A
Superficial
Swelling
• Filled
With
A
Cheese
Like
Or
Oily
Material.
• Grows
Slowly
Not
Painful.
• How
We
Have
Reached
To
Diagnosis
• Based
On
The
Clinical
History
And
Physical
Examina:on
Findings
• Biopsy
Or
An
Ultrasound
Examina:on
Performed
To
Exclude
Alterna:ve
Pathology
9. Sebaceous
Cyst
• Therapeu:c
interven:on
• Small
non
inflamed
-‐-‐-‐-‐
no
need
any
therapeu:c
interven:on.
•
For
acutely
inflamed
cysts-‐-‐-‐-‐
a
short
course
of
an:bio:cs
• Recurrent
infec:ons
or
very
large
cysts
may
warrant
drainage
and/or
excision.
10.
Fibroadenoma
• Ultrasonography
features
• Classic
Appearance
• Well
Defined
•
Smoothly
Marginated
• Hypoechoic
11.
Fibroadenoma
• Risk
Factors
And
Cause
• Unknown
E:ology
• Most
Common
Benign
Tumors
Of
The
Breast
• Risk
Factor
The
Use
Of
Oral
Contracep:ves
Before
Age
20
Years
• These
Tumors
Have
An
Increased
Risk
For
Breast
Cancer
(About
A
1.5-‐2
Times
Greater
Risk
Than
That
Of
Women
Without
Breast
Changes).
12.
Fibroadenoma
• A
defini:ve
diagnosis
• The
tumors
are
mobile
and
composed
of
glandular
and
stromal
elements
• Typically
made
based
on
findings
from
imaging
studies
(eg,
ultrasonography,
mammography)
and
biopsies.
• Lesions
that
are
atypical
on
ultrasonography,
are
larger
than
2
cm,
or
exhibit
rapid
growth
should
be
biopsied.
• Treatment
• Removal
of
the
lesions
is
generally
recommended,
and
it
is
usually
done
by
formal
surgical
excision.
• Smaller
lumps
can
be
removed
by
minimally
invasive
techniques,
such
as
vacuum-‐assisted
biopsy
or
cryoabla:on.
14.
Fibrocys:c
Diseases
• What
are
fibrocys:c
changes
• Changes
In
The
Glandular
And
Stromal
Tissues
• Commonly
In
Young
• Although
Breast
Cysts
Can
Occur
At
Any
Age
• Cysts
Are
Generally
Mul:ple
• May
Be
Unilateral
Or
Bilateral
• Wax
And
Wane
With
The
Menstrual
Cycle
• What
are
Symptoms
• include
swollen,
tender/painful,
and/or
thick
or
lumpy
breasts;
some:mes
a
discharge
is
present.
15. Fibrocys:c
Diseases
• Ultrasound
study
and
fine-‐needle
aspira:on
(FNA)
is
usually
obtained.
• Although
most
cysts
are
considered
benign
• Warning
signs
that
require
addi:onal
workup
include
1. Bloody
aspira:on
2. Failure
to
completely
collapse
upon
aspira:on
3. Solid
:ssue
components.
16. Fibrocys:c
Diseases
No
Defini:ve
Treatment
• Suppor:ve
Measures
1. Analgesics
2. Applying
Heat/Ice
• Pharmacotherapy
1. Oral
Contracep:ves,
2.
Tamoxifen
3.
Androgens
• Aspira:on
May
Performed
• For
Symptoma:c
Relief
• Repeated
Aspira:ons
May
Be
Needed
As
Cysts
Recur
17. Breast
TB
• Incidence
increases
to
3-‐4%
in
areas
with
endemic
TB
such
as
India
and
Africa)
• Classified
as
nodular,
diffuse,
or
sclerosing.
• Most
commonly
seen
in
young
lacta:ng
mul:parous
women.
18. Breast
TB
Typical
features
of
Breast
TB
• A
unilateral
painless
breast
mass
• Specially
in
the
middle
or
upper
outer
breast
quadrant
• Persistent
draining
sinus
• Axillary
lymphadenopathy
• Nipple
retrac:on.
• Breast
cancer
must
be
ruled
out
• Pa:ents
generally
do
not
have
systemic
TB
19. Breast
TB
• workup
• Ziehl
Neelsen
staining
or
culture
for
acid-‐fast
Bacilli
(gold
standard)
• Mantoux
tes:ng
• Fna
• Polymerase
chain
reac:on
• Histopathology,
and
imaging
studies
(eg,
ultrasonography,
computed
tomography,
nuclear
MRI).
• Treatment
•
Involves
an:-‐TB
chemotherapy
and
surgery.
20. Phyllodes
Tumor
• Younger
pa:ents
are
less
likely
to
have
malignancy
•
so
clinicians
must
formulate
an
age-‐
appropriate
differen:al
diagnosis
list.
• This
ultrasound
image
shows
a
in
a
young
woman—a
typically
benign
tumor
with
malignant
poten:al
that
should
be
excise
21. Phyllodes
Tumors
• also
known
as
cystosarcoma
phyllodes,
• stromal
tumors
of
the
breast.
• They
are
most
common
• These
can
be
• large,
• painless,
• rapidly
growing
tumors
• that
are
difficult
to
dis:nguish
clinically
from
giant
fibroadenomas.
22. • Phyllodes
tumors
should
be
treated
with
complete
surgical
resec:on.
In
adults,
a
1-‐cm
surgical
margin
is
recommended.
• However,
there
is
some
thought
that
adolescent
phyllodes
tumors
are
less
aggressive
and
a
smaller
surgical
margin
may
be
acceptable.
23. Primary
Breast
Cancer
• Primary
Breast
Cancer
Is
Rare
In
Children
And
Adolescents.
•
Less
Than
1%
Of
Breast
Cancer
Pa:ents
Are
Younger
Than
30
Years
• The
Incidence
Of
Breast
Cancer
In
Women
Younger
Than
20
Years
Is
1
In
1,000,000.
24. Primary
Breast
Cancer
• Thirty-‐nine
cases
of
primary
breast
cancer
in
pediatric
pa:ents
have
been
published
to
date.
• Younger
pa:ents
are
more
likely
than
older
adults
to
present
with
a
large
mass
at
the
:me
of
breast
cancer
diagnosis.
25. Primary
Breast
Cancer
•
Physical
exam
demonstrates
a
firm,
nonmobile,
poorly
circumscribed
mass,
similar
to
adult
women
with
breast
cancer.
• However,
nipple
retrac:on
and
discharge
appear
less
common
in
children.
26. Secretory
adenocarcinoma
• (Formerly
known
as
juvenile
carcinoma)
• Most
common
primary
breast
cancer
• Popula:on
and
accounts
for
31
of
the
39
reported
cases
(84%).
• Unique
capsule
that
is
thick
walled
27. Secretory
adenocarcinoma
• The
mass
to
appear
cys:c
on
ultrasound.
• Slow-‐growing
and
benign
clinical
picture.
• (9.7%)
iden:fied
nodal
metastases
at
the
:me
of
surgical
excision
• No
mortali:es
have
been
published
secretory
adenocarcinoma;
• Long-‐term
follow-‐up
data
are
lacking
28. • Medullary
carcinoma
has
been
reported
in
six
pa:ents
under
the
age
of
18
years
(11%),
four
of
whom
expired
from
associated
metasta:c
disease.
• less
common
than
secretory
carcinoma
but
are
associated
with
more
aggressive
disease
pathology.
• Two
cases
of
inflammatory
cancer,
both
12-‐year-‐
old
girls,
have
been
published,
with
one
death
and
no
follow-‐up
reported
on
the
other
pa:ent.
29. Work
up
• surgical
management
of
primary
breast
cancer
remains
controversial.
•
Complete
surgical
resec:on
is
the
goal
in
all
cases,
• however,
maintaining
normal
breast
development
should
also
be
considered
whenever
possible.
30. Work
up
•
The
need
for
axillary
lymph
node
staging
or
axillary
dissec:on
remains
unclear.
• With
at
least
9.7%
nodal
metastases
observed
in
secretory
carcinoma
• the
aggressive
nature
of
medullary
and
inflammatory
cancers,
recommend
lymph
node
staging
in
all
pa:ents.
31. Work
up
•
Axillary
ultrasound
for
clinical
preopera:ve
workup,
as
in
adults,
is
recommended.
•
Extrapola:ng
from
management
of
breast
cancers
in
adults,
sen:nel
lymph
node
surgery
for
nodal
staging
is
recommended
for
clinically
node-‐nega:ve
cases
and
axillary
dissec:on
for
node
posi:ve
cases.
32. Work
up
•
Furthermore,
radia:on
and
chemotherapy
can
be
associated
with
increased
risk
of
subsequent
cancers
in
young
pa:ents;
• therefore,
risk
and
benefit
should
be
carefully
considered
based
on
tumor
type
and
stage
of
disease.
33. • Radia:on
exposure
for
girls
during
peak
breast
development,
typically
10
to
16
years
of
age,
is
most
harmful.
• Approximately
40%
of
girls
treated
with
radia:on
for
Hodgkin
lymphoma
will
develop
breast
cancer;
it
takes
an
average
of
20
years
to
develop.
• For
these
women,
annual
clinical
breast
examina:on
and
annual
MRI
for
screening
of
breast
cancer
development
is
recommended
• bilateral
prophylac:c
mastectomies
to
decrease
risk
of
breast
cancer
development
can
be
considered.
34. Management
Of
Breast
Masses
• Conserva:ve
• Guided
By
Clinical
Diagnosis
• Diligent
Follow-‐up.
Palpable
symptoma:c
cysts
– ultrasound-‐guided
fine-‐needle
aspira:on,
– with
collapse
of
the
cyst
– clinical
follow-‐up
to
assess
stability.
35. Management
Of
Breast
Masses
Fibroadenomas
• Clinical
observa:on
over
two
to
four
months
is
appropriate.
• grow
by
more
than
1
cm,
and
those
larger
than
2
cm
warrant
directed
• to
confirm
that
they
are
benign
– Ultrasonography
– Percutaneous
Biopsy
36. Management
Of
Breast
Masses
Surgical
excision
recommended
in
the
situa:ons
– Mass
Larger
Than
5
Cm
– (Even
If
Biopsy
Confirms
A
Fibroadenoma),
– Rapidly
Enlarging
Mass
– Pain
– Distor:on
Of
The
Breast
Architecture,
–
Skin
Changes.
37. Management
Of
Breast
Masses
Surgical
excision
– Large
Masses
Is
Recommended
– Prevent
Distor:on
Of
Breast
Architecture
– Need
For
Augmenta:on
To
Fill
The
Postopera:ve
Defect.
Surgical
exper:se
is
cri:cal
to
protect
the
development
of
the
breast
bud
while
maintaining
a
good
cosme:c
outcome.
38. Breast
Mass
Disconcer:ng
Can
Provoke
Anxiety
Fear
First
Point
Of
Contact,
And
Should
– Ini:ate
Appropriate
Inves:ga:on
– While
Providing
A
Respeciul,
Communica:ve
Approach
– Alleviate
Anxiety
And
Body
Image
Issues.
39. Management
Of
Breast
Masses
Use
Of
Minimally
Invasive
Procedures,
Such
As
Cryoabla:on
Of
Masses
In
Adolescents,
Is
Limited.
In
Pa:ents
Who
Do
Not
Accept
Surveillance
Of
Mul:ple
Or
Small
Masses
(Less
Than
2
Cm)
And
Who
Are
Concerned
About
Surgical
Scarring,
Management
With
Vacuum-‐assisted,
Ultrasound-‐guided
Percutaneous
Excision
Can
Be
An
Alterna:ve
To
Surgery
40. Clinical
assessment
• History:
the
site,
dura:on,
associated
pain,
rela:onship
to
menstrual
cycle
and
any
recent
change
in
the
size
of
the
lump
should
be
established.
•
Any
previous
history
of
breast
lumps,
relevant
inves:ga:ons
or
opera:ons
should
be
noted.
41. Clinical
examina:on
• Both
breasts
should
be
examined
• Site,
size
and
consistency
of
lump
• Area
of
abnormal
texture
should
be
noted
• Correlated
clearly
with
the
site
of
symptoms
• Any
associated
signs
of
malignancy
such
as
skin
tethering
or
nipple
inversion
should
be
sought.
• The
axillary
and
the
supraclavicular
lymph
nodes
should
be
examined
42. Assessment of the axilla
• Ultrasound
of
the
axilla
should
be
carried
out
in
all
pa:ents
when
malignancy
is
expected.
•
If
lymph
nodes
showing
abnormal
morphology
on
ultrasound
are
found,
needle
sampling
should
be
carried
out
under
ultrasound
guidance.
• Lymph
node
sampling
may
be
performed
using
FNAC
or
needle
core
biopsy
43. One-‐stop
assessment
Triple
assessment
are
performed
during
a
single
visit
this
provides:
• A
basis
for
defini:ve
diagnosis
• Reassurance
with
no
need
for
further
alendance
• Informa:on
for
mul:disciplinary
mee:ng
(MdM)
• Treatment
planning
prior
to
review
of
those
diagnosed
to
have
cancer
44. Outcome
of
assessment
• Following
triple
assessment,
a
defini:ve
diagnosis
of
either
benign/
physiological
changes
or
malignancy
will
be
made
in
most
pa:ents.
• Where
a
defini:ve
diagnosis
is
not
established,
repeat
clinical
assessment
and
needle
biopsy
should
be
considered.
45. Breast mass : etiology
§ More than 90% of palpable breast
masses in adolescence
§ Differential Diagnosis:
ü Fibrocystic changes
ü Fibroadenoma
ü Fat necrosis
ü Phyllodes tumor
ü Intraductal papilloma
ü Breast cancer
46. • Breast
Masses
from
Metasta:c
Disease
• Breast
masses
caused
by
metasta:c
disease
have
also
been
described
in
pediatric
pa:ents
and
are
more
common
than
primary
breast
cancer.
• Primary
malignancies
have
included
• hepatocarcinoma,
• non-‐Hodgkin
lymphoma,
47. Conclusion
• Pediatric
and
adolescent
breast
masses
are
fortunately
uncommon
and
unlikely
to
require
surgical
interven:on
48. Conclusion
• Thus
limited
data
are
available
pertaining
to
their
management.
• However,
cases
of
malignancy,
including
phyllodes
tumors,
ductal
adenocarcinomas,
and
metasta:c
lesions,
have
been
documented
in
children
and
adolescents.
49. CONCLUSION
• The
preferred
imaging
modality
in
adolescents
is
breast
ultrasonography
• Which
can
beler
characterize
and
delineate
breast
masses,
differen:ate
cys:c
from
solid
masses
• Increase
sensi:vity
while
avoiding
radia:on
exposure.
50. CONCLUSION
Mammography
is
rarely,
if
ever,
indicated
in
adolescents
because
of
the
dense
nature
of
the
breast,
which
significantly
reduces
mammographic
sensi:vity.
When
a
malignancy
is
suspected,
magne:c
resonance
imaging
may
be
useful
to
evaluate
the
extent
of
disease.
51. CONCLUSION
• Tailor
Care
Of
The
Adolescent
• Recognizing
The
Differen:al
• Importance
Of
Diligent
Follow-‐up
• Take
A
Conserva:ve
Approach.
52. CONCLUSION
When
clinical
features
provoke
concern
for
a
higher-‐risk
mass,
exper:se
with
this
adolescent
popula:on
is
important
to
op:mize
outcomes.
53.
Dr.
Kawita
Bapat
• MS.FICOG
• DIRECTOR OF ONE CENTRE FOR GYNAECOLOGICAL EXCELLENCE
• Senior practicing OBGYN at Indore
• ONE DAY HYSTERECTOMY SPECIALIST
• FOGSI Affiliated colposcopy center
• Chairperson female breast diseases committee FOGSI
• Past president OBGYN Society INDORE
• GOVRNING COUNCIL MEMBER ICOG
• Past President LIONS Club INDORE
• TREASURER IMS INDORE Chapter
• Award winner of Nayika Indore and captain of industry
• bapatkawita@gmail.com
• www.onegynae.com
• BAPAT HOSPITAL BAPAT CHORAHA SUKHLIA INDORE
• +919826055666
54. BREAST COMMITTEE ROADMAP
Establishing Awareness in Public & OBGY domains
• Detailing a module about breast health
• Communication Collaterals like:
• PowerPoint presentation
• Handbills
• Pamphlets
• Books
• Monthly magazine or newsletter
• Encouraging sharing of stories about breast cancer
survivors
• Adolescent breast health checkup, counseling &
knowledge enrichment
• Educational Seminars
55. BREAST COMMITTEE ROADMAP
• Collaborations with NGOs, Clubs & other social & community organizations
• Celebrity endorsements by those celebrities who are already working for
breast health
• Spreading knowledge about Mammography Screening, Breast checkups in
all corporate and social units
• Frequent awareness rallies
• Grand Marathon Events with mass participation where people will Run for
Breast Health Awareness
• Participation & support from in international agencies and organization
• Collaboration with government & related units that can help the cause