1. BREAST CANCER
Dr/Omar Hashim

2. Breast position &anatomy
3. Breast anatomy
The breasts are specialized accessory glands
Of the skin that capable of secreting milknipple small and surrounded by areola. The breast tissues consists of ducts embedded in connective tissue. The breast extended from2nd intercostals up word to the 6th intercostals down ward & from lateral margin ofsternum to the midaxillary line the majar part of the breast lies in the superficial fascia. Small part called called axillary tailextended to the deep fascia
4. 5. each breast consists of 15-20 lobs which radiated outfrom
The nipple .the main duct from each lobes open separately
On the nipple .these is fibrous tissue in between for sport
And take the breast it isnormal feature
Lymphdrainage ;- for lymph drainage the breast is divided
Into quadrants , the lateral ones drainage to the
axillary the medial ones drainage internal thoracic groups
Then to the SCV . The axillary lymph nodes divided into three
Levels by relation to pectorals minor muscle ;-
Level one ;-(low axillary)= nodes inferior and lateral to the
-Pectoralis mi
Level tow ;- (mid axillary) =nodes directly beneath the
Pectoralis minor muscle.
Rotters ;-interpectoral nodes consider level tow and are
6. Between pectoralis major & minor .
Level three ;-nodes superior/medial to the pectoralis minor
7. BETOF MATTEDAXILLARY LYMPH NODS
8. 9. Epidemiology &Etiology
The second common cancer in USA representing 26% of all cancer . And 15% of all cancer deaths . Is the 1st leading cause of.*caner death in women over 65 yrs . Breast cancer is more common in whites women but black women are more likely to die from their disease .
Risk factors;- past history---BRCA1&BRCA2 --age ---early menarche late menopause nilliparty firstbirth after the age 30 yrs Atypical lobular hyperplasia Atypicalductalhyperplasia long term postmenopausal estrogen replacement early exposure to ionizing radiation
10. Pathology of ca breast
The breast canceris divided into two major group 1)insitu carcinoma2) invasive carcinoma . The insitu subtypes inculed ;- ductal carcinoma insitu DCIS 15-20% --lobular carcinoma insitu LCIS
the invasive carcinoma subtypes include ;- 70-80% infiltrating duct cell carcinoma . 10% infiltrating lobular . The remainingofthe invasivesubtypes are mucinous, tubular, .papillary, & medullary
Pagets disease is nipple involvement withdisease
11. ductal carcinoma in stu
12. 13. Invasive ductal carcinoma
14. Invasive lobular carcinoma
15. Bagetdisease
16. Imagingscreening

Screening lead tobreast cancer mortality in age*1

17. (in mammography)only10%ca breast can not be detected 18. Clinical breast exam every 1-3 yrs & periodic self exam recommended in young adulthood 19. Annual clinical exam & screening mammog- 20. Raphy to 40-50 yrs in USA 21. Screening mammography MRI in high risk pts 22. (mantlefild RT-pt with genetic factors- *2