PIPRAMS

GREATER NOIDA

LESSON PLAN
ON
BREAST CANCER

SUBJECT - PATHOPHYSIOLOGY
IDENTIFICATION DATA:

Name : Suman Pandey

Topic : Breast Cancer

Batch : B.SC N 2 RD YR.

Duration : 45 minutes

Methods of teaching : Lecture-cum-discussion

A.V Aids : Blackboard, Flash card, leaflet and PPT.

General objectives:

At the end of the presentation, the students will be able to understand and gain adequate
knowledge about Group Therapy.

Specific objectives:

At the end of the presentation, students will be able to;

 To explain about Introduction.

 To explain about Definition.
 To describe causes and risk factors.
 To explain about Pathophysiology.
 To explain about Symptoms.
 To describe Diagnostic tests.
  To explain about Treatment.

S.NO TIME SPECIFIC CONTENT TEACHING A-V EVALUTAION

OBJECTIVE ACTIVITY AIDS
1. 2Min. To explain about
Introduction
INTRODUCTION Lecture
cum
PPT What do you
understand by
- Discussion Introduction?
Cancer is a dreadful disease.
80% to 90% of all cancers are
the result of the things we do
to ourselves. Among women
breast cancer is the second PPT What is definition
2. 2 Min. To explain about most common cancer. Breast Lecture of Breast Cancer?
Definition cum
cancer is the most common
malignant condition of breast. Discussion

DEFINITION -
Breast cancer is the most What are the
To explain about
3. 5 Min. Causes And risk common malignant condition PPT causes of Breast
of breast. Malignant means Cancer?
factors Lecture
cells that grow harmfully and
cum
uncontrollably.
Discussion
 CAUSES
• Hormonal factors like when
the cells come in contact with
estrogen
• Genetic factors like gene
mutation

RISK FACTORS
• Starting menopause at a
later age Having no children
or having a first child after
age 30
• Women with previous Flow
4. 5 Min history of breast cancer chart
To explain steps Describe steps of
Not breastfeeding Lecture
of Pathophysiology?
Using birth control pills cum
Pathophysiology
Being overweight after Discussion
menopause
Having first menstruation
before age 12 or entering
menopause after age 55.
Drinking alcohol (more than
one drink a day)
• lack of exercise

PATHO
PHYSIOLOGY
▸ Breast cancer, like other
cancers, occurs because of an
interaction between an
environmental (external)
factor and a genetically
susceptible host.
About 90% of breast cancers
are due to genetic
abnormalities that happen as a
result of the aging process
and the “wear and tear” of life
in general.
The etiology of breast cancer
is still poorly understood with
known cancer risk factors
explaining only a small
proportion of cases.
Breast tissues consist mainly
of fatty tissue interspersed
with connective tissue.
Each tissue has 15 to 20
sections that are termed as
Lobes. Inside each lobe are
many smaller structures
called Lobules/Ducts that
contain mammary glands.
➤ Oxygen, nutrients, and
other life-sustaining
nourishment are delivered to
breast tissue by the blood in
the arteries and capillaries.
Lymph ducts: Drain fluid that
carries white blood cells (that
fight disease) from the breast
tissues into lymph nodes
under the armpit.
Lymph nodes: Filter harmful
bacteria and play a key role In
fighting off infection.
 90% of cases are reported
with ductal carcinoma.
Lobular carcinoma is very
rare. If cancer confines to
duct it is benign or in situ but
if move beyond duct, termed
as malignant or invasive.
Genetic abnormality due to
5. 2 Min any mutation allows the cells
to divide more rapidly than
To explain healthy cells do and may Leaflet
symptoms spread through the breast, to What are the
the lymph or to other parts of Lecture Symptoms of
the body (metastasize) e.g. cum Breast Cancer?
lungs or liver. Discussion

It has also been observed that

breast stromal cells can
modulate the growth of
normal and neoplastic breast
epithelial cells and can
secrete growth factors
following stimulation by
6. 5 Min. endogenous hormones. The
adipose tissues contain PPT
To explain aromatase enzyme, which
Diagnostic tests produces oestradiol from What is
in detail circulating cholesterol. Lecture mammogram?
Because of the higher cum
proportion of these fat cells in Discussion
breasts of older women, the
levels of oestradiol in are
much greater than their
plasma levels. This probably
accounts for the rising
incidence of breast cancer
with ageing and supports the
role of steroid hormones in
the pathogenesis of breast
cancer.
Symptoms
 Lump in the breast
tissue > Dimpling of
skin
➤ Skin irritation
 ➤ Red Scaly Patch on Skin
 Swollen Lymph Nodes
➤ Constant Pain in breast and
armpit area

Diagnostic
Parameters
Mammogram:
A mammogram is a special
type of X-ray taken to look
for abnormal growths or
changes in breast tissue.
Breast Ultrasound:
7. 5 Min. An ultrasound can distinguish
between a solid mass, which
may be cancer, and a fluid- PPT
To explain the filled cyst, which is usually
treatment in not cancer.
detail What you
MRI: Lecture understand by
MRI may be used to find out cum chemotherapy?
how much the disease has Discussion
grown throughout the breast
the tissue.
Biopsy:
Removal of cells from a
suspicious mass to see if it's
cancer or not.

Positron Emission
Tomography:
PET may also be used to find
out whether the cancer has
spread to organs.

Molecular Testing of
Tumor:
The standard tests to further
evaluate the cancer include
estrogen receptor (ER), HER-
2 tests. The presence of these
receptors helps determine the
type of treatment that is most
likely to lower the risk of
recurrence. Generally,
hormonal therapy works well
for ER-positive cancers, also
called hormone receptor-
positive cancers. If a person’s
tumor does not have ER, the
tumor is categorized as
negative tumor type. This
type of cancer usually grows
and spreads more quickly
than hormone receptor-
positive disease.

Treatment
The American Joint
Committee on Cancer
(AJCC) and The International
Union against Cancer (UICC)
recommend TNM staging.
Their TNM system, which
they now develop jointly,
classifies cancer by several
factors, T for tumor, N for
nodes, M for metastasis and
helpful to some extent in
treatment approaches.
 T describes the size of
the original (primary)
tumor and whether it
has invaded nearby
tissue,
 N describes nearby
(regional) lymph nodes
that are involved,
 M describes distant
metastasis (spread of
cancer from one part of
the body to another).
The management of breast
cancer depends on various
factors, including the stage of
the cancer and the age of the
patient. Breast cancer is
usually treated with surgery,
which may be followed by
chemotherapy or radiation
therapy, or both. A
multidisciplinary approach is
preferable. Hormone
receptor-positive cancers are
often treated with hormone-
blocking therapy over courses
of several years. Monoclonal
antibodies, or other immune
modulating treatments, may
be administered in certain
cases of metastatic and other
advanced stages of breast
cancer.
1. Surgery-
Mastectomy: Removal of the
whole tissue.
Lumpectomy: Removal of a
small part of the tissue.
2. Medication-
There are currently three
main groups of medications
used for adjuvant breast
cancer treatment after
surgery.
Hormone Blocking
Therapy: Some breast
cancers require estrogen to
continue growing. These ER+
cancers can be treated with
drugs that either block the
receptors, e.g. Tamoxifen, or
alternatively block the
production of estrogen with
an Aromatase inhibitor, e.g.
Anastrozole or Letrozole. The
use of tamoxifen is
recommended for 10 years.
Chemotherapy:
Chemotherapy is
predominantly used for Cases
of breast cancer estrogen
receptor-negative (ER-)
disease. The chemotherapy
medications are administered
in combinations, usually for
periods of 3-6 months. One of
the most common regimens,
known as “AC”, combines
Adriamycin(Doxorubicin)+
Cyclophosphamide. Another
common treatment is
Cyclophosphamide+
Methotrexate+ Fluorouracil
(or “CMF”)
3. Radiotherapy-
Radiotherapy is given after
surgery to the region of the
tumor bed and regional lymph
nodes, to destroy microscopic
tumor cells that may have
escaped surgery.
Cancer’s Seven Warning
Signals-
C - Change in bowel or
bladder habits
AA sore that does not heal
U- Unusual bleeding or
discharge
T - Thickening or lump in the
breast or elsewhere
I - Indigestion or difficulty in
swallowing
O - Obvious change in wart
or mole
N - Nagging cough or
hoarseness
Awareness Programs-
Ribbon Awareness Campaign
You can be a victim of cancer
or a survivor of cancer.
It's a mind-set.