BREAST CANCER GROUP 6 : Nuraini Ikqtiarzune Haryono(14700006) Tri Wahyu Ningsih (14700014) Rani...
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Transcript of BREAST CANCER GROUP 6 : Nuraini Ikqtiarzune Haryono(14700006) Tri Wahyu Ningsih (14700014) Rani...
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BREAST CANCER
• GROUP 6 :Nuraini Ikqtiarzune Haryono (14700006)Tri Wahyu Ningsih (14700014)Rani Yuswandaru (14700020)Anita Rheza Fitriana Putri (14700030)Ahmad Tio (14700038)Nikolas Bell (14700046) Febryyani Rahmayanti (14700086)
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What is Breast Cancer?
• The most common type of cancer in women in the United States (excluding cancers of the skin) and the second most frequent cause of death from cancer in women
• A disease in which normal cells in the breast begin to change, grow without control, and no longer die
• Cancer that has not spread is called in situ, meaning “in place”
• Cancer that has spread is called invasive or infiltrating
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What Are the Risk Factors for Breast Cancer?
• Age• Race• Individual or family history of breast cancer• A history of ovarian cancer• A genetic predisposition (mutations to the BRCA1 or BRCA2 genes
cause 2% to 3% of all breast cancers)• Estrogen exposure• Atypical hyperplasia of the breast• Lobular carcinoma in situ (LCIS)• Lifestyle factors (obesity, lack of exercise, alcohol use)• Radiation
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Breast Cancer and Early Detection
• Early diagnosis means a better chance of successful treatment
• Mammography is the best tool doctors have to screen for breast cancer
• Many organizations recommend that women obtain a mammogram each year, starting at the age of 40
• Regular clinical breast examinations and breast self-examinations are also recommended
• Women are encouraged to discuss the frequency of screening with their doctors
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What Are the Symptoms of Breast Cancer?• New lumps or a thickening in the breast or under the arm
• Nipple tenderness, discharge, or physical changes
• Skin irritation or changes, such as puckers, dimples, scaliness, or new creases
• Warm, red, swollen breasts with a rash resembling the skin of an orange
• Pain in the breast (usually not a symptom of breast cancer, but should be reported to a doctor)
• No visible or obvious symptoms (asymptomatic)
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How is Breast Cancer Evaluated?
• Screening and/or diagnostic mammography
• Ultrasound
• Magnetic Resonance imaging (MRI) scan
• Biopsy is necessary to confirm a diagnosis
• Blood tests are often used to determine if the cancer has spread outside the breast
• Additional tests may be used to determine stage
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Breast Cancer Staging
• Staging is a way of describing a cancer, such as the depth of the tumor and where it has spread
• Staging is the most important tool doctors have to determine a patient’s prognosis
• Staging is described by the TNM system: the size of the Tumor, whether cancer has spread to nearby lymph Nodes, and whether the cancer has Metastasized (spread to organs such as the liver or lungs)
• The type of treatment a person receives depends on the stage of the cancer
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Stage 0 Breast Cancer• Known as “cancer in situ,” meaning the cancer
has not spread past the ducts or lobules of the breast (the natural boundaries)
• Also called noninvasive cancer
• Ductal carcinoma in situ (DCIS) is the most common in situ breast cancer
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Stage I Breast Cancer
• The tumor is small and has not spread to the lymph nodes
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Stage IIa Breast Cancer• Stage IIa breast cancer
describes a smaller tumor that has spread to the axillary lymph nodes (lymph nodes under the arm), or a medium-sized tumor that has not spread to the axillary lymph nodes
• Stage IIa may also describe cancer in the axillary lymph nodes with no evidence of a tumor in the breast
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Stage IIb Breast Cancer
• Stage IIb breast cancer describes a medium-sized tumor that has spread to the axillary lymph nodes
• Stage IIb may also describe a larger tumor that has not spread to the axillary lymph nodes
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Stage IIIa Breast Cancer
• Stage IIIa breast cancer describes any size tumor that has spread to the lymph nodes
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Stage IIIb Breast Cancer
• Stage IIIb breast cancer has spread to the chest wall, or caused swelling or ulceration of the breast, or is diagnosed as inflammatory breast cancer
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Stage IIIc Breast Cancer
• Stage IIIc breast cancer has spread to distant lymph nodes but has not spread to distant parts of the body
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Stage IV Breast Cancer• Stage IV breast cancer can be any size and has
spread to distant sites in the body, usually the bones, lungs or liver, or chest wall
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How is Breast Cancer Treated?
• Treatment depends on stage of cancer
• More than one treatment may be used
• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy
• Targeted therapy
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Factors Considered in Treatment Decisions
• The stage and grade of the tumor
• The tumor’s hormone receptor status (ER, PR)
• Factors that may signify an aggressive tumor, such as HER-2/neu amplifications
• The presence of known mutations to breast cancer genes
• The patient’s menopausal status
• The patient’s age and general health
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Cancer Treatment: Surgery
• Generally, surgery to remove the tumor with or without radiation therapy is initial treatment
• For invasive cancer, lymph nodes are removed and evaluated
• More invasive surgery (such as mastectomy) is not always better; discuss with your doctor
• Breast reconstruction is an option after mastectomy
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Cancer Treatment: Adjuvant Therapy
• Treatment given in addition to surgery to reduce the risk of recurrence
• May include radiation therapy, chemotherapy, biologic therapy, and hormone therapy
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Cancer Treatment: Radiation Therapy
• The use of high-energy x-rays or other particles to destroy cancer cells
• Usually used to treat breast cancer after surgery
• Different methods of delivery
• External-beam: outside the body
• Internal: uses implants inside the body
• Side effects may include fatigue, swelling, and skin changes
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Cancer Treatment: Chemotherapy
• Drugs used to kill cancer cells
• May be given before surgery to shrink a large tumor (neoadjuvant chemotherapy) or after surgery to reduce the risk of recurrence (adjuvant chemotherapy)
• A combination of medications is often used
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Cancer Treatment: Hormone Therapy
• Used to manage tumors that test positive for either estrogen or progesterone receptors
• May be used alone or together with chemotherapy
• Tamoxifen (Nolvadex) is a common hormone therapy and is effective in many premenopausal and postmenopausal women
• Aromatase inhibitors are also used alone or following tamoxifen use as treatment for postmenopausal women, including anastrozole (Arimidex), letrozole (Femara), and exemestane (Aromasin)
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New Therapies: Targeted Therapy• Treatment designed to target cancer cells while minimizing damage
to healthy cells
• Used to stop the action of abnormal proteins that cause cells to grow and divide out of control
• Trastuzumab (Herceptin) for women with a HER-2/neu-positive breast cancer either with or after adjuvant chemotherapy
• Bevacizumab (Avastin) blocks angiogenesis (the formation of new blood vessels) and is under evaluation in clinical trials
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Thank you