han

1. Breast
Cancinoma
Clinical feactures and its Staging
~Rahul.B

2. It is a most common presentation and the
most common site is upper outer quadrant
DISCRETE LUMP

3. • Nipple retraction
• Nipple discharge
NIPPLES

4. • Ulceration
• Peau de orange
• satellite nodule
• Dimpling /tethering
SKIN
CHANGES

5. It is the sign of locally advanced
diseases due to the obstruction of
cutaneous lymphatic drainage by
infiltration of subdermal
lymphatics or axilary lymph nodes
PEAU D ORANGE

6. Cancer en cuirasse
It is due to the extensive tumour infiltration of the
skin of the breast ,chest , upper limb and abdomen

7. Any symptoms due to
distant metastasis
bony pain, cough, breathlessness,
haemop-tysis, headache, visual
disturbances, neurological deficit,
epileptic fits, abdominal distension,
jaundice, anorexia, weakness, weight
loss, hypercalcaemia

8. TNM STAGING
• TX-Primary tumor cant be assessed
• T0-No evidence of Primary Tumor
• Tis(DCIS)-Ductal carcinoma in situ
• Tis(Pagets)-PAGETS diseases of the nipple not associated
with (Paget's) invasive carcinoma and/or carcinoma in situ
(DIS) in the underlying breast parenchyma
• T1-Tumour <20 mm in greatest dimension
T1mi-Tumour ≤1 mm in greatest dimension
T1a-Tumour >1 mm but 55 mm in greatest dimension
(round any measurement >1.0-1.9 mm to 2 mm)
T1b-Tumour >5 mm but ≤10 mm in greatest dimension
T1c-Tumour >10 mm but ≤20 mm in greatest
dimension
TUMOUR

9. TNM STAGING
TUMOUR
• T2-Tumour >20 mm but ≤50 mm in greatest
dimension
• T3-Tumour >50 mm in greatest dimension
• T4-Tumour ofany size with direct extension to
the chest wall and/or to the skin

10. TNM STAGING
NODES
• cNx-Regional lymph node cant be assessed
• cN0-No regional lymph node metastasis
• cN1-Metastasis to movable ipsilateral level 1
and 2 axillary lymph nodes
• cN2-Metastases in ipsilateral level I, Il axillary
lymph nodes that are clinically fixed or matted;
or in ipsilateral internal mammary nodes in the
absence of axillary lymph node metastases

11. TNM STAGING
NODES
• cN3a-Metastases in ipsilateral infraclavicular
(level III axillary) lymph node(s) with or without
level I, Il axillary lymph node involvement
• cN3b-Metastasis in ipsilateral internal
mammary lymph node(s) with level I, Il axillary
lymph node metastases;
• cN3c-Metastases in ipsilateral supraclavicular
lymph node(s) with or without axillary or internal
mammary lymph node involvement

12. TNM STAGING
METASTASIS
• M0- No clinical or radiological evidence of
distant metastasis
• cM1- distant metastasis by radiological and
clinical means

13. THANK YOU