MeDiCaL ScHoOoL

MeDiCaL ScHoOoL

Saturday, January 12, 2008

A TUMOR ATLAS


Breast



RISK FACTORS, BREAST CANCER


Female sex, Advanced age ,Previous history of breast cancer, Family history ,Nulliparity Benign breast disease ( Multiple papillomatosis ), Early menarche Late menopause ,Irradiation ,Obesity Alcohol ,

Contraceptive pill & hormone replacement therapy



Duct cell carcinoma of breast

Early disease:
Palpable mass, Breast pain Nipple discharge ,Ulceration, Skin dimpling, Edema ,Erythema Axillary mass Scaling of the nipple (Paget's disease)


Advanced disease:
Fixation of the mass to the chest wall , Axillary lymphadenopathy , Edema of the arm, Breast enlargement , Ulceration , Supraclavicular lymphadenopathy ,Back pain Bone pain, Jaundice and Weight loss



Detects tissue asymmetry, abnormal masses, microcalcifications, and skin thickening




Radiologic procedures:



Chest X- rays may show pulmonary metastases

CT scans of liver & brain may show systemic metastases

Radionuclide bone scanning may show metastatic lesions




Fine needle aspiration cytology:



An out patient procedure

Immediate results

Relatively atraumatic

Can not differentiate between in-situ & invasive carcinoma

Can distinguish ductal from lobular carcinoma



Core biopsy:



An out patient procedure performed under local anesthesia

In-situ disease can be differentiated from invasive disease

A greater appraisal of the grade & type of tumor is possible




Open surgical biopsy:
Requires hospital admission.

Usually done under general anesthesia

A definitive method for the diagnosis of disease




Ultrasound:
Differentiates cystic from solid lesions

Is not diagnostic of malignancy




Other laboratory tests:


Consistently elevated erythrocyte sedimentation rate

Elevated serum alkaline phosphatase

Hypercalcemia

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