Overview of Breast Cancer

Dr. Rizwana SyedM.D.

Ob Gyn

Breast Cancer Facts

2nd leading cause of death2nd most common cancerIncidence increases with age

All women are at risk

How is the Breast DesignedThe 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 CancerDuctal CarcinomaDuctal 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 CancerObesityDiet: Fat

Alcohol

Lack of Physical Activity ; StressRadiation ExposureHistory 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 controlledcontrolled All

women are at risk

Obesity Exercise

Breastfeeding Alcohol

HormoneReplacement

Therapy

Not having children

Screening For Breast Cancer

A Good Breast Health Plan• Self Awareness (Monthly

Self Exams) (BSE)

• Clinical Breast Examination (CBE)

• Mammograms

Screening Average-size lump found by woman practicing occasional breast self-exam (BSE)

Average-size lump found by woman practicing regular breast self-exam (BSE)

Average-size lump found by first mammogram

Average-size lump found by getting regular mammograms

riz

Breast Self Examination (BSE)• Opportunity for woman to

become familiar with her breasts

• Monthly exam of the breasts and underarm area

• May discover any changes early

• Begin at age 20, continue monthly

When to do BSE

• Menstruating women- 5 to 7 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 3 years for women between 20 and 40 yrs

• More frequent examination for high risk patients

MammographyX-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

SurgerySurgery•Lumpectomy

•Modified Radical Mastectomy

•Radical Mastectomy (rare)Reconstruction

Breast ReconstructionBreast ReconstructionPre and Post Expander and ImplantPre and Post Expander and Implant

Pre and Post Tissue and Implants CombinedPre and Post Tissue and Implants Combined

•Radiation Therapy•Chemotherapy•Hormonal Therapy

As a adjunct to surgery depending on stage of cancer

Prognosis after Breast Cancer

5-Year Survival (%)

10-Year Survival (%)

Stage 0 95 90

Stage I 85 70

Stage II 70 50

Stage III 55 30

Stage IV 5   2

Myths & Facts•Touching the breasts too often will lead to cancer

•Talking about cancer causes cancer

•Using illegal drugs causes cancer

•Herbs cure breast cancer(uña de gato/cat’s claw)

•A bruise on the breast will lead to breast cancer.

•If an incision is made during breast cancer surgery,the cancer will spread.

•Getting too many mammograms leads tobreast cancer.

•Mammograms are only used to evaluatebreast lumps.

Myths & Facts

• Breast cancer only affects older women• If you have a risk factor for breast

cancer, you're likely to get the disease• Using antiperspirants causes breast

cancer.• A breast cancer diagnosis is an

automatic death sentence.• Breast cancer is preventable

THANK YOUdrrizwanasyed@hotmail.com