PATHOPHYSIOLOGY OF BREAST CANCER

PREDISPOSING FACTORS ETIOLOGY PRECIPITATING FACTORS

Gender (Unknown) Diet
Age Hx of taking oral
Genetics contraceptives
Noncompliance to
treatment
Immunosuppression

Genetic mutation of the cellular DNA

(P53, BRCA-1, & BRCA-2 genes)

Activation of growth-promoting Inactivation of tumor suppressor Alterations in the gene that

oncogenes genes controls apoptosis

Unregulated proliferation and differentiation of

cancer cells in the milk duct

Growth of a malignant tumor

A
 A

Activation of immunologic Release of growth factors

mechanism Cancer cells destroy
normal RBCs

Cancer cells release Angiogenesis

Release of B-lymphocytes, exosomes
T-lymphocytes & Natural Anemia of Chronic disease
Killer cells
Impairment of the immune ↓ Lymphocytes
response
↓ RBC Pale nail beds
Death of some Cancer cells ↓Hgb ↓ Capillary refill

Immunosuppression

Pneumonia of Release of Neutrophils and

Crackles Immunosupression Macrophages

Malignant tumor grows

rapidly
Production of Pyrogenic
Productive cough
cytokines: (IL-1)
DOB

C B
Fever
 B

Change in symmetry or size Rapid multiplication of Malignant tumor obstructs Malignant tumor tends to compress
of the breast cancer cells the milk duct blood and lymphatic vessels

Rupture of milk duct

Rapid metabolism caused by
the cancer cells
↓ Blood supply to the
breast tissue
Inflammatory response
Normal cells are deprived of
C nutrients
Ischemia
Release of chemical
mediators:
Unexplained Bradykinins & Prostaglandins
Necrosis
weight loss

Fatigue Transient vasoconstriction

Limited ROM (3/5) F

D
E
G
 D E F G

Vasodilation Blood and lymph stasis Cancer cells begin to spread

locally via lymphatic vessels

↑Vascular permeability
Presence of cancer cells in
lymph nodes
Plasma fluid leaks into the
tissue

Palpable, immovable,
Swelling Tissue decay hard & painless nodes:
Supraclavicular and
axillary lymph nodes
(2 cm)
Compression of the nerve
endings Foul odor

Pain

Accumulation of fluid, cells

and cellular debris & live and Pus
dead lymphocytes