BREAST
CANCER
SANA MEHMOOD
Lecturer
ZCRS, Ziauddin University
BREAST CANCER
► Breast cancer is the most
common malignant condition
of breast. Malignant means
cells that grow harmfully and
uncontrollably.
RISK FACTORS
► Gender: female
► Age: increases as a woman gets older.
► Relative : other or sister
► Menstrual history :early on set/late menopause
► Childbirth: first child After the age of 30 or
having no children at all
►Pregnancy and breastfeeding are protective against breast cancer
RISK FACTORS
►Obesity
►Diet
►Lack of Physical Activity ; Stress
►Radiation Exposure
►History of cancer: breast, uterus, cervix, ovary
►Hormones: estrogens in Hormone replacement
therapy & Birth control pills
►> 70% have no risk factors
ANATOMY OF BREAST TISSUE
❑ The breast sit on the chest
muscles that cover the ribs.
❑ Each breast is made of 15 to 20
lobes.
❑ Lobes contain many smaller
lobules.
❑ Lobules contain groups of tiny
glands that can produce milk.
❑ Milk flows from the lobules
through thin tubes called ducts to
the nipple.
❑ The nipple is in the center of a dark
area of skin called the areola.
❑ Fat fills the spaces between the
lobules and ducts
Lymph Nodes of the Breast
Subclavian
nodes
Axillary
nodes
Parasternal
Lateral nodes
pectoral
nodes
BREAST ANOMILIES
❑ Inverted nipple: congenital or due to cancer
❑ Ectopic nipple:
a. “polythelia” or “hyperthelia”
b. additional nipples
❑ Amastia
❑ Micromastia
❑ Macromastia
❑ Gynecomastia
a. Abnormal breast development of male
b. noted in males who smoke marijuana at puberty
Benign breast conditions
► A benign breast condition refers to a lump, cyst, or
abnormal nipple discharge (fluid) of the female or male
breast that is not cancerous. For women, the most common
ones are: Fibrocystic breast changes. Fibrosis feels like scar
tissue and can be rubbery and firm.
► Most common benign conditions
❖ Mastalgia
❖ Nipple Discharge
❖ Benign breast masses
Benign Conditions, continued
4. Tumors & cysts
a. Fibroadenoma =
most common
benign breast
tumor
Tumors & cysts, continued ….
Intraductal papilloma
- may produce
“chocolatey” or
bloody discharge from
nipple
e. Lipoma: common
- fatty tumors
Carcinoma of the breast
Breast cancer is the most common invasive
cancer in women and the second leading cause
of cancer death in women after lung cancer.
SYMPTOMS
The first symptoms of breast cancer usually appear as an area of thickened
tissue in the breast or a lump in the breast or an armpit.
Other symptoms include:
•pain in the armpits or breast that does not change with the monthly cycle
•pitting or redness of the skin of the breast, similar to the surface of an
orange
•a rash around or on one of the nipples
•discharge from a nipple, possibly containing blood
• a sunken or inverted nipple
• a change in the size or shape of the breast
• peeling, flaking, or scaling of the skin on the
breast or nipple
Screening
► 1. SBE (self-breast examination)
► 2. Mammography
Self Breast Examination
► Self Breast Exams are an important way to find a
breast cancer early.
► Not every cancer can be found this way, but it is
critical to become familiar with your breasts in order
to identify an abnormality
► SBE should be done once a month approximately
1wk after your menstrual period
Self Breast Exam cont’d
► Lumps
► most women have lumps or lumpy areas in the breast that
may be the result of Fibroadenomas or Cysts
► 8 out of 10 lumps removed from the breast are benign
► Upper/outer area(armpit) - most prominent lumps/bumps
► Lower half - sandy/pebbly beach
► Underneath nipple - collection of large grains
► Other parts - lumpy bowl of oat meal
Steps to a Self Breast Exam:
Step 1
► Look in the mirror, shoulders straight and
arms on hips.
► Look for size, shape, and colour of
breasts, is there any distortion or swelling
present
► Changes to report: dimpling, puckering,
bulging of the skin, change in nipple
position, inverted nipple, redness,
soreness, rash or swelling.
Step 2
► Raise arms above
head and look for
the same changes.
Step 3
► Still standing at the mirror, look for any
discharge/fluid coming from nipples.
► Changes to report: any fluid coming out of 1 or
both nipples (unless the female is lactating).
Could be watery, milky, yellow or bloody.
Step 4
► Lie down on the bed and
palpate breasts using pads
of a few fingers.
► Use a firm smooth touch in
a circular motion.
► Cover entire breast – collar
bone to top of stomach,
armpit to sternum.
► Make sure to follow a
pattern so to cover all area
of the breasts.
Step 5
► Sit or stand and
palpate the breast in
the same manner as
step 4.
► Changes to report:
lumps, bumps,
irregularities
Mammography
► Breast imaging technique
► Identifies non-palpable masses and diagnoses palpable masses
► Procedure takes approximately 15 minutes
► Breast is compressed from top to bottom, and side to side
► New and old mammograms are compared
American Cancer Society
Guidelines for mammography
► Women ages 40 to 44 should have the choice to start annual
breast cancer screening with mammograms (x-rays of the
breast) if they wish to do so.
► Women age 45 to 54 should get mammograms every year.
► Women 55 and older should switch to mammograms every
2 years, or can continue yearly screening.
Diagnosis for Breast Cancer
► Procedures for tissue analysis:
► Percutaneous Biopsy
► Fine-Needle Aspiration
► Surgical Biopsy
► Excisional Biopsy
► Incisional Biopsy
► An open biopsy that removes only part of a lump of suspicious tissue is called an incisional biopsy; one that
removes the entire lump is called an excisional biopsy.
Grading
Staging
Treatment
► Surgery
► Chemotherapy
► Radiation
► Adjunctive Therapy
► Alternative Therapy
Breast Sparing Surgery:
► Lumpectomy; is a surgical removal
of a discrete portion or "lump" of
breast tissue
► Partial Mastectomy; An operation to
remove the cancer and some normal
tissue around it, but not the Whole
breast itself
Modified Radical Mastectomy
Total Mastectomy
TRAM Flap Reconstruction
Mastectomy Complications
► Infection
► Lymphedema
► Hematoma/Seroma
Formation
► Allergic Reaction
Physical Therapy post mastectomy
care
❑Restoring movement in arms or shoulders
❑Maintaining muscle, bone, and tissue
flexibility
❑Restoring your full range of motion and
daily activities
❑Lymphatic drainage
❑Encouraging emotional and mental
resilience
Lymphatic drainage Video Links
► https://www.youtube.com/watch?v=zSXIcxwkc6A&t=31s
► https://www.youtube.com/watch?v=ClB_nqi2u04&t=932s
