The research was carried out at the MVJ Medical College & Research Hospital.

1. Dr Sharanya Rajan
MVJ Medical College & Research Hospital
Breast Cancer Awareness

2. Introduction
The complaining of breast lump ranging frm 40_70%

3. Evaluation of breast lump
Diagnosis
History and
examination
imaging
Cytology
and
histology

4. History taking

6. Physical examination
General examination
Position

7. Inspection

8. Palpation

10. Primary analysis
Painless lump:
Carcinoma
Cyst
Fibroadenoma
Area of fibroadenosis

11. Painful lump:
An area of fibroadenosis
Cyst
Periductal mastitis
Abscess
Carcenoma

12. Nipple changes
Destruction
Depression
Discolouration
Displacement
Deviation
Discharge
Duplication

13. Nipple discharge
Red (blood)
Pink (serum+blood)
Clear pale yellow
Brown
Green
Black
Creamy white or yellow
Thin white

14. Nipple discharge
Duct ectasia
Intraduct papilloma
Ductal carcinoma in-situ
Associated with cyst

15. Imagimg
Mammograpgy
Used for screening in women >40 years of age
Computer aided detection and diagnosis(CAD)
Use computer for better visualization of lump
3D mamography
The machine move in an arc around the breast to give 3 dimention
picture

17. BI-RADS system categories:

18. MRI
can diffrentiate between scar tissue and recurrent lesion
can be used in women with implant
know used for screnning
Ultrasound
Can diffrentiate between solid and cystic lesions
Used for guided aspiration

19. Ductoscopy
To visulization of duct and take biopsy from abnormal
areas
Ductogram
Inject a contrast material through the tube inserted in
the duct and see the lining of the duct
Diffuse optical tomography
Detect the percentage of HB saturation during take full
inspiration
Positron emission mammography
Use sugar attach to radioactive materials to detect
malignant calls

20. Nuclear medicine
studyScintimammography
Use radioactive tracer which is accumulate in the tissue and
emmit gamma rays
which is detected by gamma
camera
Thermpgraphy
Have high failure rate .. Detect 1 from 4 malignant masses
Other experimental imiging
Optical imiging
Pass light through breat tissue and measure the light which is
pass or return through the tissue
Molecular breast imaging
New nuclear medicine imaging technique

21. Cytology and histology

22. Core needle biopsy
To diffrentiate between ca in situ and invasive ca
Fine needle diopsy
Less invasive but have high failure rate
Vacuum biopsy
For removal of microcalcifications

24. Pathological classification of breast
lumps
Epithelial:
Duct papilloma
Connective tissue:
Neurofibroma
Lipoma
Mixed:
Fibroadenoma
Phyllodes tumor
Benign
Inflammatory
carcinoma
Malignant
Invasive duct
carcinoma

26. Benign breast lumps
Others •
Inflammation •
Infection •
Pregnency •
related
Injury •
Hematoma
Fat necrosis
Galactocele
Puerperal
abscess
Breast cyst
Fibroadenom
a of breast
Acute
bacterial
mastitis
Duct ectasia
tuberculosis
http://www.healthplus24.com/womens-health/breast-cancer/breast-lump.aspx

27. Breast Cyst
Smooth, unilateral mass
Feels like a cyst
Infrequently associated
with malignancy
Aspirate
Watch for reforming of
cyst
Recurring cysts are more
worrisome.

28. Galactocele
Milk-filled cyst
Usually follows lactation
Firm, tender mass
Usually in upper quadrants
Diagnostic aspiration often curative

29. Galactocele

30. Galactocele

31. Fibroadenomas
Causes
Types
Treatment

32. Fat Necrosis
Symptoms
Causes
Treatment

33. Lipoma

34. Fibrocystic breasts
Aberrations of normal development and
involution (ANDI)
Symptoms
Causes
Complications
Treatment

35. Fibrocystic breasts
Aberrations of normal development and
involution (ANDI)
Clinical features:
It most commonly affect women between (30-
50) years of age.
The symptoms of ANDI include an area of
lumpiness and/or breast pain (mastalgia).
The changes may be cyclical, with an increase in
both lumpiness, and often tenderness, before a
menstrual period.
No consistent association between fibrocystic
complex and breast cancer.

36. Fibrocystic breasts
Aberrations of normal development and
involution (ANDI)

37. Mastitis
Types
Symptoms
Breast abscess
Causes
Treatment
Risk factors
Weaning

38. Tuberculosis of the breast
Tuberculosis of the breast
with secondary suppurating
axillary lymph nodes

39. Breast Cancer
Epidemology

40. Risk factors
Age
Previous
history of
breast
disease
Previous
history
of breast
cancer
Family
history
of
breast
cancer
lifestyle genetics
http://www.medscape.com/viewarticle/443381_13

41. Signs and symptoms

42. Clinical presentation
breast cancer commences most frequently in
the upper, outer quadrant

43. Classification
Histopathology
Grade
Stage

44. Stage 1A

45. Stage 1B

46. Stage 2A

47. Stage 2B

48. Stage 3A

49. Stage 3B

50. Stage 4

51. Treatment Medication
Hormone therapy

52. Chemotherapy
CMF
CAF (or FAC)
TAC
AC → T
FEC → T
TC
TCH

53. Monoclonal antibodies
Naked monoclonal antibodies
Conjugated monoclonal antibodies

54. Radiation

55. surgery

56. Screening
Average-risk women
Above-average risk women

57. Self examination

58. Clinical Breast Examination
Mammography
MRI