1. Prof Mr Anil Sivasankaran
BREAST
Prof Mr Anil Sivasankaran

2. BREAST Surgical Anatomy. Axillary Tail of Spence. Lobule.
Ligaments of Cooper.
Areola.
Nipple.
Lymphatics.

3. BREAST INVESTIGATIONS: Mammography. Ductography. Thermography.
Ultrasound.
Needle Biopsy.
Chest X-Ray.

4. BREAST NIPPLE: Papilloma of Nipple.
Retention Cyst of Gland of Montgomery.
Chancre of the Nipple.
Eczema of Nipples.
Paget’s disease of the Nipple.

5. BREAST
NIPPLE DISCHARGES:
Clear Serous.
Blood Stained.
Black or Green.

6. BREAST CYSTIC SWELLINGS. DUCTS: Fibroadenosis
Intracystic Papilliferous Carcinoma.
Galactocele.
Papillary Cystadenoma.
Serocystic of Brodie.

7. BREAST STROMA: Colloid degeneration of Carcinoma. Lymphatic Cyst.
Hydatid Cyst.

8. BREAST NEOPLASMS. BENIGN: Epithelial-Duct Papilloma/Pure Adenoma.
Connective Tissue-Neurofibroma/Lipoma.
Mixed-Fibroadenoma.

9. BREAST FIBROADENOMA: Pericanalicular or Intracanalicular.
Solitary, Well Defined, Firm, Lobulated Extremely Mobile Lump of 1-3 cms.
Well Defined Capsule.
Malignant Changes rarely occurs.
Treatment is Enucleation via Cosmetic Incision.

10. BREAST MASSIVE BREAST SWELLINGS. Diffuse Hypertrophy.
Giant Fibroadenoma.
Cystosarcoma Phylloides.

11. BREAST CARCINOMA. Scirrhous Carcinoma. Atrophic Scirrhous Carcinoma.
Duct Carcinoma.
Medullary Carcinoma.
Inflammatory Carcinoma.
Paget’s Disease of the Nipple.
Lipomatous Carcinoma.

12. BREAST SCIRRHOUS CARCINOMA: Commonest Form of Ca.
Middle & Elderly Aged Women.
Hard Lump due to abundance of FT.
Indrawing of Nipple, Skin Overlying and Tethering of Pectoral Fascia as Tumour progresses.
Peau d’orange, ulceration, skin fixation to chest wall.

13. BREAST ATROPHIC SCIRRHOUS CARCINOMA:
Aged thin woman with small breast.
Mainly Fibrous Tissue, less Cellular elements.
Chronic Course.
Upto 10 years to ulcerate.

14. BREAST DUCT CARCINOMA: 40 YRS AND ABOVE. Blood Stained Discharge.
Difficult to distinguish with Duct Papilloma.
Need Biopsy.

15. BREAST MEDULLARY CARCINOMA: 5% . Younger age groups.
Soft & Circumscribed, may become Large.
Good Prognosis.

16. BREAST INFLAMMATORY CARCINOMA: Mastitis Carcinomatosis.
Rare Highly Progressive Cancer.
Painful Diseased Breast/Retracted Nipple.
Reddened Skin is Warm, Tender with Cutaneous Oedema.
DDX-Breast Abscess

17. BREAST PAGETS DISEASE OF THE NIPPLE:
Superficial Manifestation of Underlying Breast Ca.
Eczema like condition of Nipple & Areola.
Nipple Eroded & destroyed.
Underlying Ca will be seen later.

18. BREAST LIPOMATOUS CARCINOMA:
Scirrhous Carcinoma may contract a covering soft tissue to mimic a lipoma.
True lipoma is extremely rare-so do a Biopsy.

19. BREAST
T.N.M. CLASSIFICATION:
Stage 1.
Stage 2.
Stage 3
Stage 4.

20. BREAST TREATMENT: Lumpectomy. Mastectomy. Radical Mastectomy.
Radiotherapy.
Chemotherapy.
Breast reconstruction.

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