breast cancer

Overview of Breast Cancer Dr Rizwana Syed M.D Ob Gyn Breast Cancer Facts  2nd leading cause of death  2nd most common cancer  Incidence increases with age  All women are at risk How is the Breast Designed The breasts 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 Types of Breast Cancer Ductal Carcinoma • • • • Originate in ducts that carry milk to nipples If cancer confined to duct = in situ (DCIS) Usually found on mammogram If moved beyond duct = invasive or infiltrating Lobular Carcinoma rare What causes Breast cancer • Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material) However, only 5-10% of cancers are due to an abnormality inherited from your mother or father About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general Risk Factors for Breast Cancer Gender: female (1% males) Race: more common in whites Age: increases as a woman gets older Relative : (mother 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 for Breast Cancer Obesity Diet: Fat Alcohol Lack of Physical Activity ; Stress Radiation Exposure History of cancer: breast, uterus, cervix, ovary Hormones: estrogens in Hormone replacement therapy & Birth control pills Genetics : certain conditions that are inheritated > 70% have no risk factors Symptoms of Breast Cancer Early breast cancer may not have symptoms Diagnosis of Breast Cancer Prevention Breast Cancer Risk Factors that can be controlled Obesity Not having children All women are at risk Breastfeeding Exercise Hormone Replacement Therapy Alcohol When to BSE • Menstruating women- to days after the beginning of their period • Menopausal women same date each month • Pregnant women – same date each month • Takes about 10 minutes • Perform BSE at least once a month • Examine all breast tissue Why don’t more women practice BSE • • • • • Fear Embarrassment Youth Lack of knowledge Too busy, forgetfulness Clinical Breast Examination • Performed by doctor or trained nurse practitioner • Annually for women over 40yrs • At least every years for women between 20 and 40 yrs • More frequent examination for high risk patients Mammography X-ray of the breast Has been shown to save lives in patients 50-69 Data mixed on usefulness for patients 40-49 Normal mammogram does not rule out possibility of cancer completely Women (asymptomatic) 40 years of age and older should have a MAMMOGRAM every year Treatment for Breast Cancer • • • • Surgery Radiation Therapy Chemotherapy Hormonal Therapy Surgery •Lumpectomy •Modified Radical Mastectomy •Radical Mastectomy (rare) Reconstruction Breast Reconstruction Pre and Post Expander and Implant Pre and Post Tissue and Implants Combined •Radiation Therapy •Chemotherapy •Hormonal Therapy As a adjunct to surgery depending on stage of cancer