Pathophysiology

Invasive Ductal Carcinoma Breast Cancer Stage

4

Toxin build up in the breatIncreased cell proliferationIncreased Estrogen metabolismToxin interfere the circulation in the lymphatic systemExposure to Parabens (chemical present in antiperspirant which is a weak estrogen-like substanceIncreased Estrogen levelFemale, Early Menarche (11 years old), Age(53), Nulliparous, AsianEtiology:UnknownModifiable factors:EndometriosisLong- Term use of Antiperspirant

Initiation phase

Carcinogen binds to cells DNA resulting to alteration of function

Genotoxic waste in estrogen metabolism takes place

Error in cellular replication

Proto-oncogenes becomes oncogenesAlteration of the tumor suppressor genes takes place

Cells divide rapidly and uncontrollably. Cancer cell grows and divides rapidly.DNA repair genes are altered and turned off.

Continuation Phase

Continuous duplication of mutated DNA

T- 2cmN- no involvementM- no metastasis

Single cell divide abnormally

Thickening/ Lump in the breastStage 1

Formation of new tissue or tumor at the right breasts milk ductsT

Not detected

Malignant conversion happens

Accumulation of cancer cells

The expanding mass compresses nearby blood vessels leading to necrosis, and area of inflammation around the tumor, increasing pressure on surrounding structures

Cells break out of the tumor and invade surrounding nodes and blood vessels.

Lymphatic Spread Hematologic Spread

Dissemination in the vesselsDissemination of the cancer cells in the lymph

T- 5cmN- (+) or (-)M- no metastasis

Cancer moves to etracellular matrix by secreting enzymes

Cells penetrate and lodges in the lymph nodes and grow Stage 2

Surrounding vessels and lymph nodes become obstructedEndothelium cracks open then causes surrounding tissue to be damaged

Entry to the blood vessels

Inflammation of the breast and swelling of the lymph nodes

Blockage of lymph nodes draining the fluidUnblocked blood vessels drain towards the venous blood flow

Cancer cells invade membrane linings

Cancer cells continue to stream in the lymph fluid

Increase capillaries

Invasive metastasis, destroying epithelial cells

Irritation and build up of fluid in adjacent tissues

T- >5cm N- (+) M- evident

Impaired lymph flow and erosion of tumor Stage 3

New Site of tumor

T- any sizeN - (+) (-)M - Distant metastasis Remains undetected and untreated

Cancer cells continue to venous blood flow and metastasize Stage 4

Detected (July 2011)

Medical management: Mastectomy (August 2011)

Diagnostic Test:Biopsy

Metastasize to the bone

Medical management: Chemotherapy

Organ Failure Poor Prognosis

LymphademaNew metastasis on lungs and other organs

DeathCardiac ArrestFailure of liver and lungs