1. BREAST CANCER PROF.NAZEM SHAMS

2. IS IT A SERIOUS PROBLEM ??

7. TYPES OF BREAST CANCER In situ  Intraductal (DCIS)  Intralobular (LCIS) Invasive  Infiltrating ductal carcinoma  Tubular carcinoma  Medullary carcinoma  Mucinous carcinoma

8. PRESENTATION :

12. CANCER BREAST Skin manifestations: 1) Skin dimpling, Tethering & Puckering:- 2) Skin fixation, ulceration & fungation 3) Nipple retraction: 4) Paget's disease of nipple 5) Peau d’orange: 6) Cancerous satellite nodules (late sign) 7) Cancer en cuirasse (very late sign) 8) Mastitis carcinomatosa 9) Malignant edema of upper limb (brawny arm) 10) Dilated veins

13. CYSTSARCOMA PHYLLOIDE TUMORS

14. dimpling

15. Nipple retraction

16. Paget disease

18. Eczema

19. Peau d’orange

20. ulceration & fungation

21. Mastitis carcinomatosa

22. satellite nodules

23. Cancer en cuirasse

24. edema of upper limb

25. Winging of the scapula

28. RISK FACTORS OF BREAST CANCER

29. BREAST CANCER PATHOLOGY

30. Tx No evidence of primary tumor Tis Carcinoma in situ T1 Tumor 2cm or < T22 to 5 cm T3T> 5cm T4a extension to chest wall T4b edema (including peau d’orange), ulceration of skin, satellite nodules T4c T4a + T4b T4d Inflammatory carcinoma

31. N0no regional lymh node met. N1Movable ipsilateral axillary l.nod. N2Fixed ipsilateral axillary lymph n. or İnternal mammary lymh nodes N3-İpsilateral supraclavicular l.n. -Fixed ipsilateral axillary lymph n. and İnternal mammary lymh nodes -İpsilateral infraclavicular l.n.

32. M0 M1

33. STAGE 1 Tumor < 2.0 cm in greatest dimension No nodal involvement (N0) No metastases (M0)

34. STAGE II Tumor > 2.0 < 5 cm or Ipsilateral axillary lymph node (N1) No Metastasis (M0)

35. STAGE III Tumor > 5 cm (T3) or ipsilateral axillary lymph nodes fixed to each other or other structures (N2) involvement of ipsilateral internal mammary nodes (N3) Inflammatory carcinoma (T4d)

36. STAGE IV (METASTATIC BREAST CANCER) Any T Any N Metastasis (M1)

38. INVESTIGATIONS :