1. عمل الطالبات : اسماء جادالله فاطمة الحشاش ختام الكفارنة

2. Breast cancer: is the development of cancer from breast tissue

3. Risk Factors for Breast Cancer n Female (1% male) n increase age n Relative (mother or sister) n Menstrual history u Early menarche u late menopause n n Nulliparity

4. What Are the Symptoms of Breast Cancer?

6. Methods of Detection n Mammography n Monthly breast self-exam (BSE)

7. Breast Self Examination n Opportunity for woman to become familiar with her breasts n Monthly exam of the breasts and underarm area n May discover any changes early n Begin at age 20, continue monthly

8. When to do BSE n Menstruating women- 5 to 7 days after the beginning of their period their period n Menopausal women - same date each month same date each month n Pregnant women – same date each month same date each month n Takes about 20 minutes n Perform BSE at least once a month once a month n Examine all breast tissue

10. Why don’t more women practice BSE? n Fear n Embarrassment n Youth n Lack of knowledge n Too busy,

11. Mammography n It help detect very small tumor long before they might be found abnormal breast examination n It should be done at 40-50years repeated every 1-2 years n Avoid do mammography week before period &don’t use powder or cream in axillary

12. Breast Cancer Staging Stage 0 – non-invasive breast cancer with no invasion of surrounding tissue

13. Stage I Breast Cancer The tumor is small and has not spread to the lymph nodes The tumor is small and has not spread to the lymph nodes measures <2 cm and there is no lymph node involvement

14. Stage Breast Cancer Stage II Breast Cancer – the tumor measures at least 2 cm but <5 cm or cancer has spread to the lymph nodes in the axilla the same side of breast

15. Stage IIIb Breast Cancer Stage IIIb breast cancer has spread to the chest wall, or caused swelling or ulceration of the breast, or is diagnosed as inflammatory breast cancer Stage IIIb breast cancer has spread to the chest wall, or caused swelling or ulceration of the breast, or is diagnosed as inflammatory breast cancer

16. Stage IIIA Breast Cancer tumor size is >5 cm or there is significant lymph node involvement, where the nodes stick to one another or surrounding tissue

17. Stage IV Breast Cancer Stage IV breast cancer can be any size and has spread to distant sites in the body, usually the bones, lungs or liver, or chest wall Stage IV breast cancer can be any size and has spread to distant sites in the body, usually the bones, lungs or liver, or chest wall

18. of breast cancer COMPLICATIONS Anémia Anorexie Fatigue Secondary infection Depression

19. - Pretreatment assessment as: 1.history & physical examination. 2.chest x-ray. 3.complete blood count. 4.liver chemistries. 5.mammography of opposite breast. 6.bone scan or liver scan. 7.tumor markers (substance produced either by tumor itself or by body in response to tumor tissue) may be present in serum.

20. TREATMENT of breast cancer Prompt Referral and Diagnosis Surgery Surgery may include : – lumpectomy – mastectomy – lymphadenectomy

21. Chemotherapy treats the entire system by disrupting the ability of cancer cells to divide and grow. A combination of drugs is often used, as different drugs attack cancer cells

22. radiotherapy involv es the use of high-energy X-rays to destroy the cancer cells. This painless administration of X-rays is usually given over a period of time to optimize the effect of destroying the cancer cells Radiotherapy may reduce the risk of recurrence by 50–60%.

23. Hormone Therapy Estrogen-sensitive cancers comprise 50–75% of breast cancers. Commonly-used hormone drugs include anti-oestrogens (e.g. tamoxifen), LHRH agonists (e.g. Zoladex) and aromatase

24. As many as 30% of women diagnosed with breast cancer will develop a depressive illness within a year of diagnosis. The psychological impact of a diagnosis of breast cancer the input of the multi-disciplinary team to support the woman and her family. Psychological Support

25. Side effects of treatment : – radiotherapy: lethargy, anorexia, localized skin reactions – chemotherapy ) nausea, vomiting, hair loss, fatigue, infections, mouth sores and irregular menstruation – hormone therapy: mood swings, depression, weight gain, hot flushes, bloating and early menopause

26. Levels of prevention 1-primary prevention -eat low fat diet -maintain weight 2-seecondary prevention -perform monthly breast self exam -mammogram 3-tertiary prevention Breast reconstruction- Arm exercise after surgery - -exercise position to prevent lymph edema