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Its about breast cancer... most common one these days! hope u find it easy nd helpful..

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  1. 2. THE ORIGIN… <ul><li>Malignant tumor developed from cells in the breast. </li></ul><ul><li>Usually either begins in the cells of the lobules , or the ducts. </li></ul><ul><li>Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes etc. </li></ul>
  2. 3. TYPES OF BREAST CANCER… <ul><li>Most common types based on its origin- </li></ul><ul><li>DUCTAL CARCINOMA :  or DCIS, starts in the cells which line the breast's ducts that supply milk to the nipple. </li></ul><ul><li>Between 85% and 90% of all breast cancers are Ductal. </li></ul><ul><li>LOBULAR CARCINOMA : or LCIS, begins in the lobes, or glands which produce milk in the breast. </li></ul><ul><li>About 8% of breast cancers are lobular. </li></ul>
  4. 5. <ul><li>Second most common types- </li></ul><ul><li>INVASIVE (INFILTRATING) FORM: - Has the potential to spread out of the original tumor site - invade other healthy parts of breast and body. </li></ul><ul><li>- This rare form of breast cancer is named for its appearance </li></ul><ul><li>NON-INVASIVE FORM : Also called In-situ. </li></ul><ul><li>It has not yet invaded other healthy tissues. </li></ul><ul><li>Can turn invasive, if left untreated. </li></ul><ul><li>Eg: DCIS, LCIS </li></ul><ul><li>INFLAMMATORY FORM:   </li></ul><ul><li>-least common, aggressive - takes the form of sheets or nests . </li></ul><ul><li>-Can start in soft tissues of the breast, just under the skin, or it can appear in the skin. </li></ul><ul><li>( Paget’s disease) </li></ul>
  5. 6. <ul><li>Breast Cancers – sensitive to Estrogen - causes tumors to grow. </li></ul><ul><li>Such cells have Estrogen receptors on their surface. – Estrogen receptor positive - ER positive cancer. </li></ul><ul><li>HER2- positive cancer : Over expression of HER2 gene causes this. </li></ul><ul><li>More aggressive and higher risk of recurring. </li></ul>
  6. 8. THE STAGES… <ul><li>Stage 0 : Cancer cells remain inside the breast duct, no invasion into normal adjacent breast tissue. </li></ul><ul><li>Stage I : Cancer - 2 cm or less - confined to the breast ( lymph nodes are clear ). </li></ul><ul><li>Stage IIA : No tumor in the breast - cancer cells in axillary lymph nodes OR  tumor - < 2 cm -has spread to axillary lymph nodes  OR  tumor - >2cm but <5 cm -has not spread to axillary lymph nodes. </li></ul>
  7. 9. <ul><li>Stage IIB : tumor >2cm but <5 cm - has spread to axillary lymph nodes  OR  tumor >5 cm - has not spread to the axillary lymph nodes. </li></ul><ul><li>Stage IIIA : No tumor in breast - Cancer in axillary lymph nodes (near the breastbone or closely stuck) OR  Any size tumor - Cancer has spread to axillary lymph nodes (near the breastbone or closely stuck) </li></ul>
  8. 10. <ul><li>Stage IIIB : Any size tumor - has spread to chest wall and/or skin of the breast -to axillary lymph nodes (clustered and close by) </li></ul><ul><li>Stage IIIC : May be no cancer in breast or Any size tumor - has spread to chest wall and/or skin of breast - lymph nodes above/below collarbone and breastbone. </li></ul><ul><li>Stage IV : cancer has spread — or metastasized — to other parts of the body. </li></ul>
  9. 11. SYMPTOMS... <ul><li>No symptoms in early stages – hence, regular breast exams. </li></ul><ul><li>Breast lump or in armpit – hard, no pain- self examination. </li></ul><ul><li>Redness, dimpling or puckering of breast. </li></ul><ul><li>Bloody, clear or yellow, green- pus like secretions. </li></ul><ul><li>Advanced symptoms- </li></ul><ul><li>Bone pain. </li></ul><ul><li>Breast pain/discomfort. </li></ul><ul><li>Skin ulcers. </li></ul><ul><li>Swelling of arm next to affected breast. </li></ul><ul><li>Rapid weight loss. </li></ul>
  11. 14. THE GENETICS BEHIND… <ul><li>BRCA1 and BRCA2 genes- </li></ul><ul><li>Help repair cell damage- normal growth of breasts. </li></ul><ul><li>Abnormal BRCA1 and BRCA2 genes - account for up to 10% of all breast cancers. </li></ul><ul><li>Not necessary that abnormal BRCA genes only cause breast cancer. </li></ul><ul><li>Mutations, especially, SNPs - linked to higher breast cancer risk in women with an abnormal BRCA1 gene as well as women who didn't inherit an abnormal breast cancer gene. </li></ul><ul><li>Mutated BRCA1 and 2 genes affect both the breasts more often. </li></ul>
  12. 15. <ul><li>Such women – ovarian, colon, pancreatic, and thyroid cancers, melanoma. </li></ul><ul><li>In men, </li></ul><ul><li>Men with mutated BRCA2 gene -higher risk for breast cancer - about 80 times greater than average. </li></ul><ul><li>Men with mutated BRCA1 gene - slightly higher risk of prostate cancer . </li></ul><ul><li>Men with abnormal BRCA2 gene -7 times more likely to develop prostate cancer. </li></ul><ul><li>Other cancer risks - cancer of the skin or digestive tract , - slightly higher in men with abnormal BRCA1 or BRCA2 genes. </li></ul>
  13. 16. <ul><li>Other genes- </li></ul><ul><li>Changes in other genes - associated with breast cancer - much less common – rarer mutations. </li></ul><ul><li>ATM : helps repair damaged DNA. </li></ul><ul><li>- abnormal copies - causes Ataxia-telangiectasia - a rare disease that affects brain development. </li></ul><ul><li>- Inheriting abnormal ATM gene - linked to an increased rate of breast cancer - abnormal gene stops cells from repairing damaged DNA. </li></ul><ul><li>p53 : Tumor suppressor. </li></ul><ul><li>- causes Li-Fraumeni syndrome – cancers at young age. </li></ul><ul><li>- Such people - higher-than-average-risk of breast cancer, leukemia, brain tumors, and sarcomas </li></ul>
  14. 17. <ul><li>CHEK2 : Tumor suppressor. </li></ul><ul><li>- Abnormal CHEK2 gene also causes Li-Fraumeni syndrome and can double breast cancer risk. </li></ul><ul><li>PTEN : helps regulate cell growth. </li></ul><ul><li>- Abnormal PTEN gene causes Cowden syndrome - higher risk of both benign (not cancer) and cancerous breast tumors, growths in the digestive tract, thyroid, uterus, and ovaries. </li></ul><ul><li>CDH1 : makes a protein that helps cells adhesion to form tissue- E-Cadherin. </li></ul><ul><li>- Abnormal CDH1 gene - rare type of stomach cancer at an early age. </li></ul><ul><li>- Women with an abnormal CDH1 gene - increased risk of invasive lobular breast cancer . </li></ul>
  15. 18. CAUSES/RISK FACTORS.. <ul><li>Family history of breast cancer (20-30% patients with history). </li></ul><ul><li>Genetic abnormality - BRCA1 and BRCA2, p53, HER2 etc. </li></ul><ul><li>Early menarch or late menopause. </li></ul><ul><li>Age and gender - Women 100 times more prone to than men. </li></ul><ul><li>Late conception. </li></ul><ul><li>DES administration during pregnancy. </li></ul><ul><li>HRT for several years. </li></ul><ul><li>Radiation exposure at young age. </li></ul>
  16. 19. TREATMENT…. <ul><li>Surgery: Lumpectomy, Quadrantectomy, Mastectomy, Sentinel node Biopsy, (Mammography) </li></ul><ul><li>Radiation Therapy and Hyperthermia </li></ul><ul><li>Chemotherapy: Taxol, 5-FU, Cyclophosphamide, Adriamycin </li></ul><ul><li>Hormonal Therapy: SERMs (Tamoxifen), Aromatase inhibitors (Aromasin) etc. </li></ul><ul><li>Targeted Biologic therapies : Anti cancer drugs- Herceptin, Avastin etc. </li></ul><ul><li>Cope with side effects. </li></ul><ul><li>Various combinations of the above therapies are employed to cure Breast cancer depending on its stage. </li></ul>
  17. 20. PREVENTION… <ul><li>Administer Tamoxifen- for women >35 years old </li></ul><ul><li>Consider prophylactic mastectomy for previously affected women, or those with strong family history. </li></ul><ul><li>Lifestyle changes. </li></ul><ul><li>Limit or stop alcohol consumption. </li></ul><ul><li>Support groups can help create awareness. </li></ul>