1. The document discusses the evaluation, diagnosis and management of breast masses. It covers the anatomy, epidemiology, clinical presentation, investigations and treatment of common benign and malignant breast conditions.
2. Investigations discussed include mammography, ultrasound, MRI and pathology tests. Malignant features on imaging include irregular masses and microcalcifications. Biopsy is needed to confirm malignancy.
3. Treatment depends on the diagnosis but includes aspiration for cysts, excision for fibroadenomas and tumors, and antibiotics for infections. Surgery is recommended for confirmed malignancies along with hormone therapy and chemotherapy.
The document discusses adenomyosis, a benign condition where endometrial tissue grows within the uterine wall. It defines adenomyosis and describes associated symptoms like pelvic pain and abnormal bleeding. Diagnosis can only be confirmed by pathology after hysterectomy, though other imaging methods like ultrasound and MRI can provide clues. TVUS shows heterogeneous myometrial texture while MRI may detect increased thickness or consistency changes in the myometrium.
This document summarizes information about uterine sarcomas, with a focus on leiomyosarcomas and endometrial stromal sarcomas. It discusses the clinical presentation, diagnostic challenges, classification, staging, prognostic factors, surgical management, and adjuvant therapies for these rare but aggressive uterine cancers. Key points include the difficulty of pre-operative diagnosis, the importance of surgical staging and cytoreduction, and the limited but emerging role of adjuvant therapies like radiation and chemotherapy.
This document discusses proliferative lesions of the endometrium including endometrial polyps, hyperplasia, and carcinomas. It provides details on the morphology, pathogenesis, risk factors, classification and clinical presentation of each condition. Endometrial polyps are benign overgrowths that can cause bleeding. Hyperplasia is an exaggerated response to estrogen and is classified based on architectural and cytological features. Endometrial carcinoma is the most common cancer of the female genital tract and arises through estrogen exposure or endometrial atrophy. Uterine fibroids are also discussed.
This document provides information about screening for cervical cancer. It discusses the magnitude of cervical cancer as the 3rd most common cancer in women worldwide. It describes the premalignant stages of cervical intraepithelial neoplasia (CIN). Risk factors for cervical cancer include human papillomavirus (HPV) infection, early age of first sexual intercourse, multiple sexual partners, and smoking. The document recommends screening strategies and discusses methods for screening including conventional Pap smear tests, liquid-based cytology, HPV testing, and visual inspection with acetic acid.
This document discusses endometrial cancer, including its risk factors, types, staging, evaluation, treatment, and prognosis. It begins with an introduction stating that endometrial cancer is the most common gynecologic malignancy in the US. It then describes the two main types (Type I and Type II), their associated risk factors and histological features. The document outlines the FIGO staging system and discusses factors that influence prognosis. It provides guidance on evaluating and surgically staging patients, including recommended procedures for different stages of disease. The principles of treatment involve hysterectomy, with additional therapies such as radiation depending on stage, grade, and other prognostic factors.
- Fibroids are benign smooth muscle tumors that arise from the uterus. They are very common, affecting 20-30% of women.
- Symptoms include heavy menstrual bleeding, pelvic pressure, pain, and infertility. Fibroids can range in size from small to very large masses.
- Diagnosis is usually made through ultrasound imaging. Surgical treatment options include myomectomy to remove fibroids or hysterectomy for multiple or large fibroids. Conservative management is also an option for small asymptomatic fibroids.
The document discusses adenomyosis, a benign condition where endometrial tissue grows within the uterine wall. It defines adenomyosis and describes associated symptoms like pelvic pain and abnormal bleeding. Diagnosis can only be confirmed by pathology after hysterectomy, though other imaging methods like ultrasound and MRI can provide clues. TVUS shows heterogeneous myometrial texture while MRI may detect increased thickness or consistency changes in the myometrium.
This document summarizes information about uterine sarcomas, with a focus on leiomyosarcomas and endometrial stromal sarcomas. It discusses the clinical presentation, diagnostic challenges, classification, staging, prognostic factors, surgical management, and adjuvant therapies for these rare but aggressive uterine cancers. Key points include the difficulty of pre-operative diagnosis, the importance of surgical staging and cytoreduction, and the limited but emerging role of adjuvant therapies like radiation and chemotherapy.
This document discusses proliferative lesions of the endometrium including endometrial polyps, hyperplasia, and carcinomas. It provides details on the morphology, pathogenesis, risk factors, classification and clinical presentation of each condition. Endometrial polyps are benign overgrowths that can cause bleeding. Hyperplasia is an exaggerated response to estrogen and is classified based on architectural and cytological features. Endometrial carcinoma is the most common cancer of the female genital tract and arises through estrogen exposure or endometrial atrophy. Uterine fibroids are also discussed.
This document provides information about screening for cervical cancer. It discusses the magnitude of cervical cancer as the 3rd most common cancer in women worldwide. It describes the premalignant stages of cervical intraepithelial neoplasia (CIN). Risk factors for cervical cancer include human papillomavirus (HPV) infection, early age of first sexual intercourse, multiple sexual partners, and smoking. The document recommends screening strategies and discusses methods for screening including conventional Pap smear tests, liquid-based cytology, HPV testing, and visual inspection with acetic acid.
This document discusses endometrial cancer, including its risk factors, types, staging, evaluation, treatment, and prognosis. It begins with an introduction stating that endometrial cancer is the most common gynecologic malignancy in the US. It then describes the two main types (Type I and Type II), their associated risk factors and histological features. The document outlines the FIGO staging system and discusses factors that influence prognosis. It provides guidance on evaluating and surgically staging patients, including recommended procedures for different stages of disease. The principles of treatment involve hysterectomy, with additional therapies such as radiation depending on stage, grade, and other prognostic factors.
- Fibroids are benign smooth muscle tumors that arise from the uterus. They are very common, affecting 20-30% of women.
- Symptoms include heavy menstrual bleeding, pelvic pressure, pain, and infertility. Fibroids can range in size from small to very large masses.
- Diagnosis is usually made through ultrasound imaging. Surgical treatment options include myomectomy to remove fibroids or hysterectomy for multiple or large fibroids. Conservative management is also an option for small asymptomatic fibroids.
This document discusses cervical cancer, including its epidemiology, risk factors, mechanisms, evaluation, staging, treatment options, and prognosis. Key points include:
- Human papillomavirus (HPV) infection is the main risk factor and causal agent for cervical cancer. High-risk HPV subtypes 16 and 18 are responsible for most cases.
- Early detection through Pap screening can prevent 30% of cases in developed countries and up to 60% in developing countries. Symptoms often include abnormal bleeding.
- Staging follows the FIGO system and determines prognosis and treatment. Surgery (e.g. radical hysterectomy), radiotherapy, and chemotherapy are common treatment options.
- Prognosis
Breast cancer awareness - Causes, Diagnosis, Treatment and PreventionMafia Rashid
This document provides information about breast cancer awareness and prevention. It notes that breast cancer is a leading cause of death in women worldwide. In Pakistan, there is a high rate of breast cancer due to lack of awareness, with approximately 90,000 new cases diagnosed annually. The document lists symptoms of breast cancer like lumps, nipple changes, and breast shape changes. It provides steps for breast self-examination and lists risk factors, treatment options, and prevention methods like diet, exercise and annual mammograms. Available mammography services in Pakistan are also outlined.
This document provides an overview of malignant ovarian tumors. It discusses the epidemiology, risk factors, pathogenesis, classification, and management of ovarian cancers. Some key points include:
- Ovarian cancer has a high mortality rate and accounts for over 50% of gynecological cancer deaths.
- Risk factors include nulliparity, family history, and hereditary conditions like BRCA mutations.
- Theories for pathogenesis include incessant ovulation and retrograde menstruation.
- The majority are epithelial tumors, most commonly serous carcinomas. Other types include mucinous, endometrioid, clear cell, and germ cell tumors.
- Early stages are often asymptomatic, contributing to late
This document provides information about cervical cancer including:
- It is caused by persistent HPV infection and is the most common cancer in women where Pap tests are unavailable.
- Risk factors include multiple sexual partners, young age of first intercourse, and smoking.
- Screening through regular Pap tests can prevent most cervical cancers by detecting pre-cancerous changes early.
- If abnormal cells are detected, a colposcopy and biopsy may be performed for diagnosis.
- Treatment options include surgery, radiation therapy, and chemotherapy depending on the stage of cancer.
- Getting vaccinated against HPV and practicing safe sex can help prevent cervical cancer.
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
This document provides an overview of endometrial carcinoma, including its epidemiology, risk and protective factors, classification, clinical presentation, diagnosis, staging, treatment, prognosis, and prevention. Endometrial carcinoma is the most common gynecological cancer and occurs most often in postmenopausal women. Risk factors include older age, early menarche, late menopause, nulliparity, obesity, and unopposed estrogen exposure. Treatment involves surgery, with additional chemotherapy, radiation, or hormonal therapy depending on the stage and grade of cancer. Prognosis depends on histologic grade and stage, with 5-year survival rates ranging from 83% for stage I to 27% for stage IV disease.
Ovarian cancer arises from the ovaries and is the 8th most common cancer in women in the US. Approximately 5,500 women in the UK and 21,000 women in the USA are diagnosed with ovarian cancer each year. Risk factors include age, nulliparity, family history, and genetic mutations. Diagnosis involves imaging tests and biopsy of suspicious tissue. Staging determines how far the cancer has spread. Treatment includes surgery to remove the ovaries and nearby tissue, followed by chemotherapy with drugs like paclitaxel and carboplatin to kill any remaining cancer cells. Chemotherapy can cause side effects by damaging rapidly dividing cells, but aims to cure the cancer or prolong life by controlling its growth.
Endometrial hyperplasia - irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium
Endometrial Ca - most common gynaecological maglinancy in the western country, endometrial hyperplasia as the precursor
Incidence of endometrial hyperplasia 3 folds higher than endometrial Ca
Fourth most common cancer in women in Peninsular Malaysia
This document summarizes information about endometrial cancer from Shaukat Khanum Memorial Cancer Hospital and Research Centre. It discusses the epidemiology, risk factors, classification, diagnosis, staging, treatment approaches including surgery and adjuvant therapy, prognosis, and recurrent disease. The summary provides an overview of endometrial cancer including that it is the most common female genital tract cancer, obesity is a strong risk factor, around 80% of cases present at an early stage, surgery is the main treatment, and refinement of adjuvant therapy for early stage disease remains challenging.
This document discusses cervical cancer screening. It begins with the epidemiology of cervical cancer, noting it is the 3rd most common gynecologic cancer in the US but 2nd most common in countries without screening. Risk factors include early sexual activity, multiple partners, HPV infection, and low socioeconomic status. Screening with Pap tests has reduced cervical cancer rates by 70% in the US. The document then discusses screening guidelines, techniques for Pap tests, interpreting results, HPV vaccination, and screening special populations like immunocompromised women.
Endometrial hyperplasia is an increased proliferation of endometrial glands relative to the stroma that can progress to endometrial carcinoma. It occurs most often in peri-menopausal women with elevated estrogen levels and is caused by prolonged, unopposed estrogen stimulation. Endometrial hyperplasia is classified as simple, complex, or atypical depending on architectural and cytological abnormalities. Endometrial carcinoma is the most common cancer of the female reproductive system, occurring most often in post-menopausal women. It is broadly classified into Type I and Type II tumors based on clinical and molecular characteristics and risk factors. Surgery is the primary treatment for early-stage disease while radiation and chemotherapy may be used
Cervical cancer is a major health problem worldwide, especially in developing countries like Egypt where it is the second most common cancer in women. Screening is important for early detection and treatment of pre-cancerous lesions to prevent the development of invasive cancer. The document discusses various screening methods for cervical cancer including cytology-based tests like Pap smears and HPV testing as well as visual inspection methods. It also reviews the prevalence of pre-cancerous lesions in Egypt and limitations of screening in low resource settings.
Endometrial cancer is the most common gynecologic cancer. It has a lifetime risk of 2.4% in white women. Risk factors include obesity, late menopause, diabetes, and unopposed estrogen exposure. Diagnosis is usually made with endometrial biopsy. Treatment involves hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. Adjuvant radiation and/or chemotherapy may be used in high risk cases. With early stage diagnosis, endometrial cancer has a good prognosis.
(I) The document discusses various types of ovarian tumours including functional cysts, inflammatory cysts, and benign and malignant neoplastic tumours.
(II) Functional cysts include follicular cysts, corpus luteal cysts, and theca lutein cysts which are usually asymptomatic and resolve on their own. Inflammatory cysts include tubo-ovarian abscesses.
(III) Benign neoplastic tumours discussed are serous cystadenoma, mucinous cystadenoma, dermoid cyst, fibroma, thecoma, and Brenner's tumour. Malignant transformations are possible in some tumour types.
This document summarizes information about cervical cancer screening in Malaysia. It discusses that cervical cancer is the 3rd most common cancer in Malaysian women. The main screening method used is the Pap smear, but newer methods like HPV testing and visual inspection are also presented. Guidelines for cervical cancer screening in Malaysia currently recommend Pap smear every 3 years for women ages 20-65, but the program could be improved as screening rates remain low and cervical cancer incidence has not decreased. The document reviews natural history, risk factors, screening modalities and their strengths/limitations, as well as guidelines for screening in Malaysia and other countries.
Cervical cancer develops in the cervix, the lower part of the uterus. It begins as pre-cancerous changes to cervical cells and can progress to cancer. About 10,520 new cases are diagnosed in the US each year, with risks highest for those who are sexually active at a young age or have HPV. Screening via Pap tests can detect cell abnormalities early when treatment is most effective. Treatment options depend on cancer stage and may include surgery, radiation, chemotherapy, or vaccines.
Adenomyosis is a benign condition where endometrial tissue grows into the myometrium. It causes the uterus to enlarge asymmetrically, especially on the posterior wall. Women with adenomyosis typically experience heavy menstrual bleeding and painful periods that can occur throughout the month. Ultrasound and MRI can detect adenomyosis by showing cysts in the thickened myometrium and an indistinct endomyometrial junction. Treatment depends on a woman's age and fertility desires, ranging from medication like NSAIDs and oral contraceptives to hysterectomy for older, parous women.
The document discusses management dilemmas in cervical cancer. It notes that cervical cancer is the third most common cancer worldwide yet is preventable. Treatment options depend on the stage of cancer and may involve surgery such as radical hysterectomy or radiation therapy. Close follow up is important after treatment due to the risk of recurrence. Proper screening and early detection are emphasized to improve outcomes for cervical cancer patients.
Fibroids are the most common benign tumors of the female reproductive system. They arise from the smooth muscle cells of the uterus and affect 20-40% of women of reproductive age. The exact cause is unknown but risk factors include age, family history, obesity, and black race. Symptoms include heavy menstrual bleeding, pain, and a pelvic mass. Diagnosis is usually made clinically or with ultrasound. Treatment depends on symptoms and desire for future fertility, and may include medication, surgery such as myomectomy or hysterectomy, uterine artery embolization, or watchful waiting.
breast diseases. shaheed.pptx Benign Breast DiseasesShaheedAlaamry2
This document discusses benign breast diseases and conditions. It covers the anatomy of the breast including arterial supply, venous drainage, lymphatic drainage and lymph nodes. It then discusses various benign breast diseases and conditions such as fibrocystic changes, fibroadenoma, mastitis, breast abscess, nipple discharge, galactorrhea and more. It also discusses congenital abnormalities and surgical importance of breast anatomy.
The document discusses breast anatomy, benign breast diseases, and risk factors for breast cancer. Some key points:
- Breast tissue is composed of lobules that drain into ducts leading to the nipple. Lymphatic drainage is primarily to axillary lymph nodes.
- The most common benign breast condition is fibrocystic changes, which causes breast tenderness and nodularity.
- Studies have found that women with benign breast disease involving atypical hyperplasia have a 2-5x increased risk of developing breast cancer later in life compared to women without these histologic findings. Early detection of breast abnormalities can improve breast cancer prognosis.
This document discusses cervical cancer, including its epidemiology, risk factors, mechanisms, evaluation, staging, treatment options, and prognosis. Key points include:
- Human papillomavirus (HPV) infection is the main risk factor and causal agent for cervical cancer. High-risk HPV subtypes 16 and 18 are responsible for most cases.
- Early detection through Pap screening can prevent 30% of cases in developed countries and up to 60% in developing countries. Symptoms often include abnormal bleeding.
- Staging follows the FIGO system and determines prognosis and treatment. Surgery (e.g. radical hysterectomy), radiotherapy, and chemotherapy are common treatment options.
- Prognosis
Breast cancer awareness - Causes, Diagnosis, Treatment and PreventionMafia Rashid
This document provides information about breast cancer awareness and prevention. It notes that breast cancer is a leading cause of death in women worldwide. In Pakistan, there is a high rate of breast cancer due to lack of awareness, with approximately 90,000 new cases diagnosed annually. The document lists symptoms of breast cancer like lumps, nipple changes, and breast shape changes. It provides steps for breast self-examination and lists risk factors, treatment options, and prevention methods like diet, exercise and annual mammograms. Available mammography services in Pakistan are also outlined.
This document provides an overview of malignant ovarian tumors. It discusses the epidemiology, risk factors, pathogenesis, classification, and management of ovarian cancers. Some key points include:
- Ovarian cancer has a high mortality rate and accounts for over 50% of gynecological cancer deaths.
- Risk factors include nulliparity, family history, and hereditary conditions like BRCA mutations.
- Theories for pathogenesis include incessant ovulation and retrograde menstruation.
- The majority are epithelial tumors, most commonly serous carcinomas. Other types include mucinous, endometrioid, clear cell, and germ cell tumors.
- Early stages are often asymptomatic, contributing to late
This document provides information about cervical cancer including:
- It is caused by persistent HPV infection and is the most common cancer in women where Pap tests are unavailable.
- Risk factors include multiple sexual partners, young age of first intercourse, and smoking.
- Screening through regular Pap tests can prevent most cervical cancers by detecting pre-cancerous changes early.
- If abnormal cells are detected, a colposcopy and biopsy may be performed for diagnosis.
- Treatment options include surgery, radiation therapy, and chemotherapy depending on the stage of cancer.
- Getting vaccinated against HPV and practicing safe sex can help prevent cervical cancer.
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
This document provides an overview of endometrial carcinoma, including its epidemiology, risk and protective factors, classification, clinical presentation, diagnosis, staging, treatment, prognosis, and prevention. Endometrial carcinoma is the most common gynecological cancer and occurs most often in postmenopausal women. Risk factors include older age, early menarche, late menopause, nulliparity, obesity, and unopposed estrogen exposure. Treatment involves surgery, with additional chemotherapy, radiation, or hormonal therapy depending on the stage and grade of cancer. Prognosis depends on histologic grade and stage, with 5-year survival rates ranging from 83% for stage I to 27% for stage IV disease.
Ovarian cancer arises from the ovaries and is the 8th most common cancer in women in the US. Approximately 5,500 women in the UK and 21,000 women in the USA are diagnosed with ovarian cancer each year. Risk factors include age, nulliparity, family history, and genetic mutations. Diagnosis involves imaging tests and biopsy of suspicious tissue. Staging determines how far the cancer has spread. Treatment includes surgery to remove the ovaries and nearby tissue, followed by chemotherapy with drugs like paclitaxel and carboplatin to kill any remaining cancer cells. Chemotherapy can cause side effects by damaging rapidly dividing cells, but aims to cure the cancer or prolong life by controlling its growth.
Endometrial hyperplasia - irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium
Endometrial Ca - most common gynaecological maglinancy in the western country, endometrial hyperplasia as the precursor
Incidence of endometrial hyperplasia 3 folds higher than endometrial Ca
Fourth most common cancer in women in Peninsular Malaysia
This document summarizes information about endometrial cancer from Shaukat Khanum Memorial Cancer Hospital and Research Centre. It discusses the epidemiology, risk factors, classification, diagnosis, staging, treatment approaches including surgery and adjuvant therapy, prognosis, and recurrent disease. The summary provides an overview of endometrial cancer including that it is the most common female genital tract cancer, obesity is a strong risk factor, around 80% of cases present at an early stage, surgery is the main treatment, and refinement of adjuvant therapy for early stage disease remains challenging.
This document discusses cervical cancer screening. It begins with the epidemiology of cervical cancer, noting it is the 3rd most common gynecologic cancer in the US but 2nd most common in countries without screening. Risk factors include early sexual activity, multiple partners, HPV infection, and low socioeconomic status. Screening with Pap tests has reduced cervical cancer rates by 70% in the US. The document then discusses screening guidelines, techniques for Pap tests, interpreting results, HPV vaccination, and screening special populations like immunocompromised women.
Endometrial hyperplasia is an increased proliferation of endometrial glands relative to the stroma that can progress to endometrial carcinoma. It occurs most often in peri-menopausal women with elevated estrogen levels and is caused by prolonged, unopposed estrogen stimulation. Endometrial hyperplasia is classified as simple, complex, or atypical depending on architectural and cytological abnormalities. Endometrial carcinoma is the most common cancer of the female reproductive system, occurring most often in post-menopausal women. It is broadly classified into Type I and Type II tumors based on clinical and molecular characteristics and risk factors. Surgery is the primary treatment for early-stage disease while radiation and chemotherapy may be used
Cervical cancer is a major health problem worldwide, especially in developing countries like Egypt where it is the second most common cancer in women. Screening is important for early detection and treatment of pre-cancerous lesions to prevent the development of invasive cancer. The document discusses various screening methods for cervical cancer including cytology-based tests like Pap smears and HPV testing as well as visual inspection methods. It also reviews the prevalence of pre-cancerous lesions in Egypt and limitations of screening in low resource settings.
Endometrial cancer is the most common gynecologic cancer. It has a lifetime risk of 2.4% in white women. Risk factors include obesity, late menopause, diabetes, and unopposed estrogen exposure. Diagnosis is usually made with endometrial biopsy. Treatment involves hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection. Adjuvant radiation and/or chemotherapy may be used in high risk cases. With early stage diagnosis, endometrial cancer has a good prognosis.
(I) The document discusses various types of ovarian tumours including functional cysts, inflammatory cysts, and benign and malignant neoplastic tumours.
(II) Functional cysts include follicular cysts, corpus luteal cysts, and theca lutein cysts which are usually asymptomatic and resolve on their own. Inflammatory cysts include tubo-ovarian abscesses.
(III) Benign neoplastic tumours discussed are serous cystadenoma, mucinous cystadenoma, dermoid cyst, fibroma, thecoma, and Brenner's tumour. Malignant transformations are possible in some tumour types.
This document summarizes information about cervical cancer screening in Malaysia. It discusses that cervical cancer is the 3rd most common cancer in Malaysian women. The main screening method used is the Pap smear, but newer methods like HPV testing and visual inspection are also presented. Guidelines for cervical cancer screening in Malaysia currently recommend Pap smear every 3 years for women ages 20-65, but the program could be improved as screening rates remain low and cervical cancer incidence has not decreased. The document reviews natural history, risk factors, screening modalities and their strengths/limitations, as well as guidelines for screening in Malaysia and other countries.
Cervical cancer develops in the cervix, the lower part of the uterus. It begins as pre-cancerous changes to cervical cells and can progress to cancer. About 10,520 new cases are diagnosed in the US each year, with risks highest for those who are sexually active at a young age or have HPV. Screening via Pap tests can detect cell abnormalities early when treatment is most effective. Treatment options depend on cancer stage and may include surgery, radiation, chemotherapy, or vaccines.
Adenomyosis is a benign condition where endometrial tissue grows into the myometrium. It causes the uterus to enlarge asymmetrically, especially on the posterior wall. Women with adenomyosis typically experience heavy menstrual bleeding and painful periods that can occur throughout the month. Ultrasound and MRI can detect adenomyosis by showing cysts in the thickened myometrium and an indistinct endomyometrial junction. Treatment depends on a woman's age and fertility desires, ranging from medication like NSAIDs and oral contraceptives to hysterectomy for older, parous women.
The document discusses management dilemmas in cervical cancer. It notes that cervical cancer is the third most common cancer worldwide yet is preventable. Treatment options depend on the stage of cancer and may involve surgery such as radical hysterectomy or radiation therapy. Close follow up is important after treatment due to the risk of recurrence. Proper screening and early detection are emphasized to improve outcomes for cervical cancer patients.
Fibroids are the most common benign tumors of the female reproductive system. They arise from the smooth muscle cells of the uterus and affect 20-40% of women of reproductive age. The exact cause is unknown but risk factors include age, family history, obesity, and black race. Symptoms include heavy menstrual bleeding, pain, and a pelvic mass. Diagnosis is usually made clinically or with ultrasound. Treatment depends on symptoms and desire for future fertility, and may include medication, surgery such as myomectomy or hysterectomy, uterine artery embolization, or watchful waiting.
breast diseases. shaheed.pptx Benign Breast DiseasesShaheedAlaamry2
This document discusses benign breast diseases and conditions. It covers the anatomy of the breast including arterial supply, venous drainage, lymphatic drainage and lymph nodes. It then discusses various benign breast diseases and conditions such as fibrocystic changes, fibroadenoma, mastitis, breast abscess, nipple discharge, galactorrhea and more. It also discusses congenital abnormalities and surgical importance of breast anatomy.
The document discusses breast anatomy, benign breast diseases, and risk factors for breast cancer. Some key points:
- Breast tissue is composed of lobules that drain into ducts leading to the nipple. Lymphatic drainage is primarily to axillary lymph nodes.
- The most common benign breast condition is fibrocystic changes, which causes breast tenderness and nodularity.
- Studies have found that women with benign breast disease involving atypical hyperplasia have a 2-5x increased risk of developing breast cancer later in life compared to women without these histologic findings. Early detection of breast abnormalities can improve breast cancer prognosis.
This document provides an overview of breast diseases, including:
- Breast anatomy and histology
- Common benign and malignant breast lesions such as fibroadenomas, phyllodes tumors, ductal carcinoma in situ, and invasive ductal carcinoma
- Risk factors, diagnostic approaches, and prognostic factors for breast cancer
It describes the clinical presentations, histopathological features, and classifications of various breast diseases.
Lecture class on pathology of breast for 3rd & 4th year MBBS students based on "Robbins & Cotran: Pathologic Basis of Disease'. Images are collected from internet.
Witch's milk in newborns is caused by maternal and placental hormones crossing the placenta and causing breast tissue proliferation before birth. This results in swelling and occasional milky discharge from nipples in both sexes during the first week, which resolves on its own as hormone levels fall.
Breast examination involves inspecting for symmetry, swelling, nipple retraction, and dimpling of skin during maneuvers that compress or lift the breast tissue. This helps identify tumors, cysts, abscesses, or signs of carcinoma.
Supernumerary or retracted nipples are congenital anomalies, while a retracted nipple in older individuals usually indicates an underlying carcinoma pulling on ducts
The document provides guidance on examining a patient's breasts and axillae. It describes the anatomy and outlines the procedure which involves inspection and palpation. Inspection involves examining the breasts visually for signs of abnormalities while palpation involves thoroughly feeling the breasts using a systematic approach to identify any masses or irregularities. Any findings should be carefully documented including location, size, shape, consistency and characteristics. The exam also includes inspecting and palpating the axillae and nipple areas.
The document discusses breast anatomy, common benign breast diseases including cysts, fibroadenomas, mastalgia and nipple discharge. It describes approaches to evaluating breast problems through history, examination, diagnostic workup and managing various benign breast conditions through lifestyle modifications, medications or surgery. The goal of treatment is to alleviate symptoms while ruling out breast cancer.
USMLE ENDOCRINE 04 Mammary glands breast ANATOMY MEDICAL .pdfAHMED ASHOUR
Surgery plays a crucial role in the management of various breast conditions, including both benign and malignant disorders. Understanding the surgical options for breast conditions is essential for breast surgeons, oncologists, and other healthcare professionals involved in breast care.
The choice of surgery depends on the specific diagnosis, patient preferences, and the overall treatment plan.
Surgical interventions aim to address the underlying condition, restore aesthetics when relevant, and contribute to the overall well-being of individuals with breast-related health concerns.
This document summarizes the development, physiology, and common conditions of the breast. It discusses:
1) Breast development during adolescence and the changes that occur with pregnancy, lactation, and after birth.
2) Common benign breast conditions like fibrocystic changes, breast cysts, fibroadenomas, galactoceles, and milk engorgement. It also discusses phyllodes tumors and mastitis.
3) Diagnostic procedures for evaluating breast abnormalities including mammography, ultrasound, MRI, fine needle aspiration, and biopsy.
This document discusses breast cancer, including its epidemiology, natural history, diagnosis, staging, biomarkers, and treatment. It notes that breast cancer is the most common cancer in women and a leading cause of cancer death. The natural history involves local growth of the primary tumor and potential metastasis to lymph nodes and distant sites like bone, lung, and liver. Diagnosis involves imaging like mammography and biopsy. Staging uses the TNM system and considers tumor size, lymph node involvement, and metastases. Biomarkers like hormone receptors provide information to guide treatment, which may include surgery, radiation, chemotherapy, hormone therapy, and targeted therapies based on cancer type and stage.
This document provides an overview of approaching a patient presenting with a breast lump. It discusses the anatomy and physiology of the breast, epidemiology of breast lumps, pathophysiology of common breast conditions, differential diagnoses, clinical assessment including history and physical exam, imaging techniques like mammography and ultrasound, histological analysis via biopsy, baseline investigations, cancer staging, and treatment options. The goal is to thoroughly evaluate any breast lump to identify serious conditions like cancer and ensure appropriate management.
This document provides an overview of benign breast problems. It discusses the anatomy and structure of the breast and provides a classification system for benign breast lesions based on histology and clinical features. Common breast problems addressed include pain, masses, cysts, and nipple discharge. Evaluation involves history, exam, and sometimes imaging or biopsy. Management depends on the specific problem but may include lifestyle changes, medications, aspiration, or surgery. The goal is to alleviate symptoms while ruling out cancer.
This document provides an overview of breast anatomy, common breast pathologies, and breast cancer. It describes the anatomy of the breast and lists common benign breast conditions like fibroadenoma, fibrocystic changes, duct ectasia, and duct papilloma. Risk factors, presentation, diagnosis, and management are discussed for breast cancer. Screening guidelines and staging of breast cancer are also reviewed. Infective mastitis in breastfeeding women is additionally covered.
The document discusses knowledge and education. It provides three key points:
1) Knowledge is only truly valuable if it brings joy and freedom, rather than making one feel wise or burdened.
2) Education must go beyond learning subjects to developing one's character and using knowledge to benefit others.
3) For education to be meaningful, it must equip people to live happily and see all of humanity, not just teach facts.
The document provides an overview of breast anatomy, physiology, examination, diseases, and tumors. It discusses the lobes, ducts, lymphatic drainage pathways, hormones, examination techniques, common breast conditions like mastitis, dysplasia, and tumors including fibroadenoma, papilloma, and carcinoma. Carcinoma is further classified and key tests are outlined to characterize tumors and guide treatment decisions.
The document discusses various benign breast diseases including congenital abnormalities, mastalgia, gynecomastia, fat necrosis, duct ectasia, galactocele, intraductal papilloma, and fibroadenoma. It provides details on the anatomy, etiology, clinical presentation, pathological features, and treatment approaches for each condition. The majority of benign breast diseases can be treated conservatively without long-term consequences.
This document provides an overview of breast disorders for medical students. It covers breast anatomy, common breast complaints including mastalgia, breast masses, and nipple discharge. For each complaint, it discusses etiology, evaluation, differential diagnosis, and management. Key benign and malignant breast conditions are described. The document emphasizes the importance of thorough evaluation of breast symptoms to diagnose breast cancers and benign lesions promptly.
This document provides information about breast cancer, including:
1) It defines breast cancer as a malignant tumor that starts in breast cells and can spread to other parts of the body.
2) Known risk factors include family history, age, and certain genetic mutations, though most women who get breast cancer have no known risk factors.
3) There are two main types of breast cancer - non-cancerous tumors and cancerous tumors that can metastasize to other organs. Prognosis depends on factors like cancer type and stage.
Breast cancer occurs in the cells of the breast and is one of the most common cancers among women. It usually begins in the lobules or ducts and spreads through the lymph nodes. Diagnosis involves physical examination, mammography, ultrasound or MRI to detect abnormalities. Biopsies of suspicious areas help determine if cancer is present. Hormone receptor status and genomic assays provide further information on prognosis and treatment options.
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
2. • INTRODUCTION
ANATOMY AND PHYSIOLOGY
OF THE BREAST
EPIDEMIOLOGY
ETIOLOGIES AND
DIFFERENTIALS
CLINICAL PICTURE
INVESTIGATION
TREATMENT
CONCLUSION
OUTLINE
3. INTRODUCTION
A breast lump/mass is a localized swelling, knot, bump, bulge or
protuberance in the breast tissue.
Breast masses may appear in both sexes at all ages.
In women, it may be due to a variety of etiologies with multiple risk
factors.
The commonest cause of a breast lump in males is gynecomastia.
Careful clinical examination and investigations are necessary to manage
breast lump.
No breast lump should be excused as benign until it has been checked by
a physician.
4. ANATOMY AND PHYSIOLOGY OF THE
BREAST
The breast (mammary gland)is a modified apocrine sweat gland.
Embryologically, the mammary glands develop from two ectodermal
thickenings, right and left (mammary ridges) which extend from the
axillae to the groins ( 4 weeks of gestation).
In humans, only the middle part of the upper third of the ridge persists
to form the breast while the rest of the line disappears.
The breasts lie between the skin and the pectoral fascia to which they
are loosely attached.
The human breast is grossly divided into 6 quadrants. UO, UI, LO, LI,
Retro-areolar and Axillary tail.
5. The adult female breast lies in an area between the 2nd and 6th
ribs and from the lateral border of the sternum to the anterior
axillary line.
The axillary tail of Spence is a prolongation of the parenchyma
which passes deeply through opening in the deep fascia to
blend with the axillary fat.
The breast tissue is supported by fibrous tissue ligaments which
run from the skin to the pectoral fascia. They are responsible for
division of the breasts parenchyma into lobes. They are called
the Cooper’s ligaments.
6. ANATOMY
The breast consists of 15-20 radially arranged
lobes and each lobe is drained by a lactiferous
duct.
The ducts converge at the nipple.
Each lobe is made up of 20-40 lobules, each of
which consists of 10-100 alveoli. It is of clinical
importance to recognize that the main ducts lie
behind the areola while the lobules lie more
peripherally.
Arterial supply: Internal mammary artery (of
axillary artery), Lateral thoracic artery, pectoral
branch of the thoraco-acromial artery.
Venous: internal thoracic, axillary and posterior
intercostal veins.
Lymphatic drainage: >75% to the axillary
nodes, <25% to the internal mammary nodes.
7. EPIDEMIOLOGY
After skin cancer, breast cancer is the most common
malignancy in women accounting for approximately 1 in 4
cancers diagnosed in women.
Breast infections occur in 10-33% of all lactating women
A study done in Enugu state Nigeria revealed 1 in 28
women(3.6%) die due to breast cancer.
Before the age of 40 years, African women have a higher
incidence, after the age of 40, Caucasian women have a
higher incidence.
9. ETIOLOGY
MALIGNANT
A. Infiltrating duct carcinoma
B. Infiltrating lobular carcinoma
C. In-situ ductal carcinoma
D. In-situ lobular carcinoma
E. Inflammatory carcinoma
12. HISTORY
Important biodata:
A.Sex
B.Age
C.Tribe/Race
D.Marital Status
PRESENTING COMPLAINTS:
1.When and how lump was first noticed
2.Associated pain, tenderness, change in size over time, changes with menstruation
3.Associated symptoms : discharge (nature of discharge), other swellings, skin changes and
body aches, Nipple changes,
4.Possible etiology: History of previous trauma, history of tuberculosis, history of similar familial
condition, Hx of drug use, Breast and skin care.
5.Complications: Weight loss, anorexia, bone pains and fractures, Cough with hemoptysis,
Jaundice, Seizures, Headaches
13. EXAMINATION
INSPECTION: Done in a sitting position, inspect for:
A. BREAST: Positioning, symmetry, size and shape compared to the other breast, visible
masses and their location
B. Skin over breast: Color, previous bruises, dilated veins, peau d’orange, dimpling, nodules,
ulceration, fungating masses
C. Nipple: Number, size and shape, Retracted, symmetry (elevated or deviated), cracks or
fissures, ulcers.
D. Areola: Color, size, surface, textures, scaliness, ulceration
E. Arms: Edema
F. Axilla and Supraclavicular regions: Fullness, swellings
G. Anterior chest wall: Nodules
14. Normal breast should be palpated first
Breast lump: Site in relation to breast quadrants (Ca breast
favors the UO quadrant), Number(multiple in case of
fibroadenosis), Shape(Irregular in Ca breast) , Size,
Surface, Consistency, Flunctuancy, Fixity to the skin, Fixity
to underlying pectoral fascia and pectoralis major, Fixity to
chest wall.
Nipple and Areola: Check for nipple retraction, any mass
deep to the nipple, press the breast segments and areola
and observe for any discharge.
Axilla and Supraclavivular fossa: Enlarged lymph nodes,
Number, size, tenderness, consistency, fixity and matting.
PALPATION
15.
16. SYSTEMIC EXAMINATION
General examination: Pallor, Jaundice, Alopecia, Cachexia,
Lymphadenopathy.
Abdominal examination: Hepatomegaly, usually nodular and
tender in malignancy
Chest examination: Dyspnea, Added sounds, signs of pleural
effusion.
Lumbar spine: Tenderness, swelling, kyphosis.
Bones: Tenderness in the ribs, sternum, pelvis and long bones.
Rectal and vaginal examination: Krukenberg tumor.
17. INTERPRETATION:
MALIGNANT BENIGN
HARD FIRM/RUBBERY
PAINLESS PAINFUL
IRREGULAR SHAPE REGULAR
FIXATION TO SKIN/CHEST WALL MOBILE/NOT FIXED
SKIN DIMPLING NO SKIN DIMPLING
DISCHARGE IS BLOODY DISCHARGE MOSTLY YELLOW/GREEN
NIPPLE RETRACTION NO NIPPLE RETRACTION
18. Fibroadenoma: It is the most common benign condition of the
breast. Found in females less than 35 years, firm, rubbery, well
circumscribed, painless swelling that increases gradually in size.Not
fixed to the skin and characteristically very mobile (breast mouse).
Fibroadenosis: Found in females 30-50 years, multiple, sometimes
painful small lumps. Mastalgia is the commonest presentation,
which is typically premenstrual and accompanied by enlargement
and increased nodularity of the breast.
Breast cysts: fluctuant swellings that gradually increase in size.
Mastitis and breast abscess: May be lactational or non-lactational.
Most common organism responsible is S.aureus. Markedly painful
breast swelling with increased redness of skin, and edema.
Differential warmth could also be elicited.
FEATURES OF COMMON BREAST MASSES
19. Breast abscess: Usually may follow mastitis, fever is hectic and pain is
throbbing. An intense course of broad spectrum antibiotics is needed followed
by incision and drainage. A breast abscess is one of the masses where a
surgeon should not wait for flunctuancy before drainage.
Duct papilloma: Usually in young women, commonly presents as bloody nipple
discharge from a single duct. Accumulated blood may be felt as a swelling
usually deep to or just lateral to the areola. Pressure on the swelling produces
discharge. Breast contour is usually preserved.
Ductile or lobular carcinoma: Usually in women older than 40. Skin changes
such as peau d’orange, skin puckering are present. Breast lump fixed to the
skin. Nipple changes as ulceration and retraction, bloody nipple discharge.
Axillary lymph nodes may be enlarged in advanced cases.
Phyllodes tumor: Rapidly growing, occurs at around the age of 40, but can
appear in younger women. Tumor is usually large, stretches the skin, may
ulcerate because of pressure necrosis and show dilated veins.
20. Tuberculosis of the breast: this is rare condition always associated with
active pulmonary tuberculosis or secondary to tuberculous cervical
lymphadenitis. The disease either presents as multiple cold abscesses
and sinuses or multiple nodules in the breast substance. The axillary
nodes are enlarged and matted and manifestations of tuberculous
toxemia are present.
21. Gynecomastia: a benign enlargement
of male breast tissue resulting from
proliferation of glandular component of
the breast tissue. Clinically presents
as firm/rubbery mass extending
concentrically from the nipples. It
should be differentiated from pseudo-
gynecomastia (lipomastia), which is
chsracterized by fat deposition without
glandular proliferation. Usually caused
by estrogen-androgen imbalance in
favor of estrogen or an increased
sensitivity of breast tissue to normal
circulating estrogen.
24. MAMMOGRAPHY
It is a soft tissue imaging of the breast. In expert
hands, it is 95% accurate in diagnosing breast
cancer.
Women aged 45 to 54 years should get a
mammogram every year. Women 55 years and
older should get mammograms every 2 years.
It is of less diagnostic value in young women in
whom the density of lesions differs little from that
of surrounding tissue.
Nipple retraction may be detected.
It can detect enlarged axillary L.N
Sensitivity is 90%
25. FEATURES OF MALIGNANCY ON MAMMOGRAM
1. Solid mass with/without stellate features
2. Asymmetric thickening of the breast mass
3. Clustered micro-calcifications
4. Spiculations
5. Duct extension
26.
27. BI-RADS CLASSIFICATION FOR MANAGEMENT OF ABNORMAL
MAMMOGRAMS
The Breast Imaging
Reporting and Data System
(BI-RADS), developed by the
American College of
Radiology, provides a
standardized classification
for mammographic studies.
This system demonstrates
good correlation with the
likelihood of breast
malignancy. The BI-RADS
system can inform family
physicians about key
findings, identify appropriate
follow-up and management
and encourage the provision
of educational and emotional
support to patients.
28. It can differentiate cystic from solid masses
Best initial treatment for women less than 35 years of age with
breast lump.
Malignant lesions appear as Elongated, hypoechoic masses with
irregular margins.
Duplex ultrasound may detect the vascularity of the gland.
Malignant lesions receive blood from all around with turbulent
speed, whereas benign lesions receive blood flow from one side
with low speed.
It is useful in young people in whom mammography is not very
helpful
BREAST ULTRASOUND
29.
30. MAGNETIC RESONANCE IMAGING
It is indicated in certain
situations such as
A. Postoperative scarring to
differentiate between fibrosis
and local recurrence of
malignancy
B. In presence of breast implants
31. INVESTIGATIONS: PATHOLOGY
A pathological evidence of malignancy is the corner stone of diagnosis. The different types of
biopsies include:
A. FNAC: Depends on examination of cells to detect the criteria of malignancy is them. It can
differentiate between benign and malignant lesions but cannot differentiate between ductal
carcinoma in situ and invasive malignancy.
B. Tru-cut biopsy: Done under local anesthesia, with a special needle that cuts a core of tissue out
of the mass. The obtained specimen allows for histological examination and for assessment of
receptors. Preferably done under US guidance.
C. Excision biopsy: It is the Gold standard technique. The whole mass is excised through a
circumareolar or transverse incision. It is the most reliable and provides big enough tissue
specimen to allow hormone receptor estimation.
D. Frozen section biopsy: The mass is either excised or incised and a diagnosis is obtained within
30mins. If it is negative for malignancy, the patient is awakened, if positive for malignancy,
surgeon proceeds for radical surgery.
32.
33. OTHERS
Baseline investigations:
A. FBC
B. RFT
C. LFT
D. ECG
E. URINALYSIS
F. SERUM Ca
Investigations for Suspected
Malignancgy:
A. Chest X-ray
B. US of Abdomen and Pelvis
C. Xray spine
D. Bone scan
E. PET Scan
F. Tumor markers: CA-15-3, CEA
G. Estrogen and progesterone receptor study
H. Sentinel LN Biopsy
34.
35. TREATMENT
Treatment is curated towards the cause of the breast mass.
Benign solid lesions may be managed expectantly, provided
regular follow up is undertaken.
Malignant solid lesions require a multidisciplinary approach
for efficient management.
36. BREAST CYST
A solitary cyst or small collection of cyst can be aspirated.
Surgical excision is done if: cyst recurs after two
aspirations, there is a bloody aspirate or residual mass is
felt after aspiration.
FNAC of any residual mass should be done after any
aspiration.
Patient should be examined for refilling of the cyst in 6
weeks.
37. Fibroadenoma: Fibroadenomas
usually do not require excision
unless associated with suspicious
pathology. Alternative therapies
include Cryoablation, heating with
high frequency ultrasound or
removal with a large core vacuum
biopsy.
Indications for surgery include:
>3cm, recurrence, multiple, giant
type.
Excision is done through a 4cm
circumareolar incision (Webster’s)
or Submammary incision (Gaillard
Thomas) to avoid ductal system.
38.
39. Conservative management including: Reassurance, avoid
caffeine, chocolate, salt
Drugs: Primrose oil( drug of choice), Gamolenic acid
120mg/day, Danazol (most effective but has drawback of
multiple side effects hirsutism, weight gain, amenorrhea),
Bromocryptine 2.5mg/day
Indications for surgery include Intractable pain, persistent
discharge and psychological reasons
Incision of choice is submammary Gillard Thomas incision.
Excision of cyst or localized excision of the diseased tissue
is done.
FIBROADENOSIS:
40. MAMMARY DUCT ECTASIA
Stop smoking
Antibiotic therapy: co-amoksiclav or flucloxacillin and
metronidazole
Cone excision of involved major ducts (Adair-Hadfield
operation)
It is important to shave the back of the nipple to ensure that all
terminal ducts are removed.
Incision of choice is infra-areola incision and should not
exceed 1/3 of the circumference of the areola.
41. DUCT PAPILLOMA
Microdochectomy: A lacrimal probe or length of stiff nylon
suture is inserted into the duct from which the discharge is
emerging.
Cone excision of the major ducts: a periareolar incision is
made and a cone of tissue is removed with its apex. The
resulting defect may be obliterated by a series of purse
string sutures
A temporary suction drain will reduce the chance of long
term deformity.
42. MASTITIS AND BREAST ABSCESS
Before the development of an abscess,
the condition is medically treated with
Broad spectrum antibiotics as Amoxicillin
clavulanic acid.
Warm fomentation
Non lactational mastitis is most commonly
due to Anerobic organisms, so it
customary to use metronidazole in
addition to amoxyclav.
Abscess is managed by Incision and
drainage. Best done under GA, a
circumferential incision is made over the
most tender area to release the pus which
is sent for C/S.
43. Tuberculosis of the breast: The treatment of breast
tuberculosis consists of anti-tubercular chemotherapy and
surgery by specific indications
Anti-tubercular chemotherapy is done for 6 months.
Excision biopsy of residual sinus tracts or lumps is done
mainly after poor response to chemotherapy.
44. Gynecomastia: initially managed medically with Androgens,
Anti-estrogens and Aromatase inhibitors.
Indications for surgical management include Ineffective
medical therapy, long standing gynecomastia and suspicion
of malignancy.
Surgical management includes excision of glandular tissue
coupled with liposuction.
Incision of choice is Gaillard Thomas sub-mammary
incision.
45. BREAST CANCER:
Management of diagnosed cases of breast cancer depends
appropriate staging of cancer
Staging can be done using the TNM system or Manchester
staging system
TNM Staging is the most commonly used .
48. Early breast cancer: Classified as TNM T1, T2, T2N1M0, and
Manchester Stage 1 and 2.
Principles of treatment include Surgery and Adjuvant therapy.
Surgery: Conservative breast surgery is indicated for tumors 5cm or
less, not centrally located, adequately sized breast and availability of
radiotherapy facilities. It entails Wide local excision of the tumor with
safety margin + removal of axillary LN and post operative radiotherapy.
(TART or QUART)
Modified radical mastectomy is indicated for patients not suitable for
CBS, large tumors, extensive calcification on mammography and poorly
differentiated tumors.It entails excision of the whole breast, axillary
clearance with sparing of the axillary vessels, nerve to latissimus dorsi
and nerve to serratus anterior.
Adjuvant therapy includes radiotherapy, chemotherapy (5-fluorouracil,
cyclophosphamide and methotrexate) and Anti-estrogen tamoxifen in
patients +ve for estrogen receptors.
49. Advanced breast cancer: T4, N2, M1 and stage 3 and
stage 4.
Very poor prognosis
Management includes Simple mastectomy +/-
Radiotherapy, Chemotherapy, Hormonal therapy and
Immunotherapy.
Hypercalcemia secondary to tumor lysis syndrome is
managed using IV Inorganic phosphate, Large doses of
furosemide and adequate hydration.
50. CONCLUSION
Although fortunately most breast masses turn out to be
benign, a thorough assessment is necessary to diagnose
very serious condition especially carcinoma
Early detection of breast cancer is the key to cure, hence
females are advised for self examination of their breast at
least once a month after their menses to catch early
disease.
A thorough history and physical examination is sufficient to
determine most probable cause of a breast mass.
51. REFERENCES
1. Kasr-el-Ainy Textbook of Surgery by Cairo University
Surgical Dept.
2. Baileys and Love’s Short Practice of Surgery 27th Edition
3. Approach to Breast Lump by Salami Ernest Osemudiamen;
Dept of Family Medicine I.S.T.H IRRUA
4. Principles and Practice of Surgery, 4th Edition; EA Badoe.
5. https://emedicine.medscape.com/article/1697353-overview