This is a lecture that will increase your awareness on breast cancer.

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Breast CancerBreast Cancer
Awareness ForumAwareness Forum
Roel S. Tolentino, MD, MBA,Roel S. Tolentino, MD, MBA, FPCS,FPCS, FACS, FPSO, FPSGS, FMOSPFACS, FPSO, FPSGS, FMOSP
General Surgery – Surgical OncologyGeneral Surgery – Surgical Oncology
Past President- Philippine Society of OncologyPast President- Philippine Society of Oncology
Professor of Surgery IVProfessor of Surgery IV

2. Memorial Sloan Kettering Cancer Center (NYC)
University Hospitals of Columbia University and Cornell Medical College
(NYC)
MD Anderson Cancer (Texas)
Beijing Cancer Hospital (China)
Chongqing Medical University (China)
Suining Central Hospital (China)
De La Salle University –De La Salle University – BS.BS.
Biology; MedicineBiology; Medicine
Manila Med –Manila Med – General SurgeryGeneral Surgery
SLMC –SLMC – Surgical OncologySurgical Oncology
Ateneo GSB -Ateneo GSB - MBAMBA
Prof. Roel Tolentino, MD, MBA

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8. • BREAST CANCER IS THE NO. 1
CANCER IN THE PHILIPPINES!
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Mastitis

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Intraductal
papilloma

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Virginal Hyperplasia

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Silicon Mastopathy

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Anatomy

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Anatomy

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Galactorrhea (paglabas ng gatas)

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Hematoma (pasa)

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Fibrocystic
changes

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Fibroadenoma and Cyst

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Phyllodes Tumor

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Gynecomastia

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Pubertal Gynecomastia
(binatang nagdadalaga)

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Failure of Breast Development

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Breast Augmentation

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Breast Augmentation

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Breast Augmentation

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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Breast Self Examination

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•
Breast Self Examination

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Breast Clinical Examination

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Physical Examination

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Palpation in
circular or radial
fashion

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Diagnostic Tests
•Mammography
•Ultrasound
•Needle Aspiration Biopsy
•Excision Biopsy
•Magnetic Resonance Imaging (MRI)

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Mammography

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Mammography

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Diagnostics
•Mammography
Cranio-caudal view

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Diagnostics
•Mammography
Oblique View

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Mammography

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Mammography

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Mammography

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Digital Mammography

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Ultrasound

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Tomosynthesis

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BIOPSY

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Needle Biopsy

63. 63Technique of Fine Needle Aspiration

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Excision Biopsy

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Open Surgical
Biopsy
Percutaneous
Biopsy
Biopsy

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Magnetic Resonance Imaging

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Magnetic Resonance Imaging

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BREAST CANCER
- Most common cancer in
the Philippines!
( Metro Manila and Rizal registry)

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Risk Factors for Breast Cancer
• Gender
• Aging
• Genetic risk factors/Family history
• Personal history of breast cancer

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Risk Factors for Breast Cancer
• Race
• Previous abnormal breast biopsy
• Previous breast radiation
• More menstrual periods

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Risk Factors for Breast Cancer
• Not having children
• Hormone replacement therapy
• Alcohol
• Obesity and high-fat diets
• Less physical activity

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Factors with Uncertain, Controversial, or Unproven Effect on
Breast Cancer Risk
• Antiperspirants
• Underwire bras
• Abortion
• Breast implants

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Early detection for breast cancer:
• 20 years or older20 years or older
– Breast self examination (BSE)
monthly.
• 20-40 years old20-40 years old
– BSE monthly.
– Physician breast examination every
3 years.

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Early detection for breast cancer:
• An initial mammogram between the
age of 35-40 years35-40 years.

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Early detection for breast cancer:
• 40-50 years old40-50 years old
– BSE monthly.
– Annual physician breast examination.
– Periodic mammography every year or
two as determined by personal history
and doctor's recommendation.

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Early detection for breast cancer:
• Over 50 years of ageOver 50 years of age
– BSE monthly.
– Annual mammography and physician
breast examination.

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Signs of Cancer
(Mass)

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Signs of Cancer
(Nipple Retraction)

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Signs of Cancer
(Distortion)

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Signs of Cancer
(Peau d’orange)

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Signs of Cancer
(Distortion, Nipple Retraction)

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Signs of Cancer
(Bloody Nipple Discharge)

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Signs of Cancer
(Scaling)
Paget’s Disease

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Signs of Cancer
(Asymmetry)

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Redness

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Signs of Cancer
(Ulceration)

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Breast Cancer with Ulcerations

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Operations for Breast Cancer

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Locally Advanced Breast Cancer
After neoadjuvant therapy

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Modified Radical Mastectomy

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Breast Conserving Surgery
-Lumpectomy
-Axillary Dissection
-Radiation Therapy

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Breast Reconstruction

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Chemotherapy

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CHEMOTHERAPY
-a systemic treatment
-4-6 cycles
-given every 21/28 days
-done as outpatient basis

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Radiation Therapy
Linear Accelerator

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Recurrence

119. TREATMENTS
• CURATIVE
• PALLIATIVE
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Disseminated Breast Cancer

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WAYS TO DECREASEWAYS TO DECREASE
THE RISK FORTHE RISK FOR
BREAST CANCER?BREAST CANCER?

123. Breast Cancer
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Early detection is the best.
Awareness of the signs and symptoms is very
important.
Go to your doctor when you have any problem with
your breast.

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roel_tolentino@yahoo.com
North 909, SLMC QC
M-W-F 3-5 pm
09164079417, 788-1412