Case 7.

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Breast Cancer
BY: Abdullatiff Sami AL-Rashed

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Objectives
1. What Is Breast Cancer.
2. Types of Breast Cancer.
3. Etiology of breast cancer.
4. Risk factors.
5. Signs and symptoms.
6. Investigations.
7. Treatment.
8. Prevention.
9. Screening.
10. Question asked by my colleagues.

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What Is Breast Cancer
 Breast cancer is a malignant
tumor that starts in the cells of
the breast.

 A malignant tumor is a group of

cancer cells that can grow into
(invade) surrounding tissues or
spread (metastasize) to distant
areas of the body.

 The disease occurs almost

entirely in women, but men can
get it, too.
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What Is Breast Cancer
 Most commonly from the inner
lining of milk ducts or the lobules
that supply the ducts with milk.

 Cancers originating from ducts

are known as ductal carcinomas,
while those originating from
lobules are known as lobular
carcinomas.

Breast cancer showing an inverted nipple,

lump and skin dimpling.
Author: Hic et nunc

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Types of Breast Cancer
 There are many types of breast
cancer:
1. Ductal carcinoma in citu (DCIS).
2. Invasive Ductal Carcinoma.
3. Inflammatory Breast Cancer.
4. Metastatic Breast Cancer.
5. Some other specific types.

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Types of Breast Cancer
1. Ductal carcinoma in citu (DCIS) :
is a non-invasive cancer where abnormal
cells have been found in the lining of the
breast milk duct.

 The atypical cells have not spread

outside of the ducts into the
surrounding breast tissue.

 Ductal carcinoma In situ is very early

cancer that is highly treatable, but if it’s
left untreated or undetected, it can
spread into the surrounding breast
tissue.
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Types of Breast Cancer

2. INVASIVE DUCTAL CARCINOMA:

 The abnormal cancer cells that began

forming in the milk ducts have spread
beyond the ducts into other parts of
the breast tissue.

 IDC is the most common type of

breast cancer, making up nearly 70-
80% of all breast cancer diagnoses.

 IDC is also the type of breast cancer

that can most commonly affects men

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Types of Breast Cancer
3. Inflammatory Breast Cancer:

 Inflammatory Breast Cancer is an an

aggressive and fast growing breast
cancer in which cancer cells infiltrate
the skin and lymph vessels of the breast.

 It often produces no distinct tumor or

lump that can be felt and isolated within
the breast.

 But when the lymph vessels become

blocked by the breast cancer cells,
symptoms begin to appear.

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Types of Breast Cancer
4. Metastatic Breast Cancer:

 The cancer has spread to other

parts of the body.

 This usually includes the lungs,

liver, bones or brain.

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Etiology
 When you're told that someone have breast
cancer, it’s natural to wonder what may have
caused the disease.

 But no one knows the exact causes of breast

cancer.

 Doctors seldom know why one woman

develops breast cancer and another doesn’t,
and most women who have breast cancer
will never be able to pinpoint an exact cause.

 What we do know is that breast cancer is

always caused by damage to a cell's DNA.

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Etiology Cont..
 But doctors have known
some risk factors that
increase the chance to get a
breast cancer.

 Women with certain risk

factors are more likely than
others to develop breast
cancer.

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Risk Factors
 There are some risk factors for the
breast cancer:
1. Gender.
2. Age.
3. Genetics related.
4. Family history.
5. Personal history of breast cancer.
6. Menstrual periods.
7. Having children.
8. Birth control.
9. Breastfeeding

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Risk Factors
1. Gender: Being a
woman is the main risk
for breast cancer.
While men also get the
disease, it is about 100
times more common in
women than in men.

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Risk Factors
2. Age: The chance of
getting breast cancer
goes up as a woman
gets older.

 About 2 of 3 women
with invasive breast
cancer are 55 or older
when the cancer is
found.

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Risk Factors
3. Genetic risk factors:
About 5% to 10% of breast
cancers are thought to be
linked to inherited changes
(mutations) in certain
genes.
3. The most common
changes are those of the
BRCA1 and BRCA2 genes.
Women with these gene
changes have up to an
80% chance of getting
breast cancer during their
lifetimes
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Risk Factors
4. Family history: Breast cancer
risk is higher among women
whose close blood relatives have
this disease.

 The relatives can be from either the

mother’s or father’s side of the
family. Having a mother, sister, or
daughter with breast cancer about
doubles a woman’s risk.

 It’s
important to note that most (over
85%) women who get breast cancer do
not have a family history of this disease,
so not having a relative with breast
cancer doesn’t mean you won’t get it.

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Risk Factors
5. Personal history of
breast cancer: A woman
with cancer in one breast
has a greater chance of
getting a new cancer in
the other breast or in
another part of the same
breast.
 This is different from a
return of the first cancer
(called a recurrence). MRI screening recommended for women with
history of breast cancer

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Risk Factors
6. Menstrual periods:

 Women who began having

periods early (before age 12) or
who went through the change of
life (menopause) after the age
of 55 have a slightly increased
risk of breast cancer.

 The increase in risk may be due

to a longer lifetime exposure to
the hormones estrogen and
progesterone.
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Risk Factors
7. Having Children:

 Women who have had no

children or who had their first
child after age 30 have a
slightly higher breast cancer
risk.

 Having many pregnancies and

becoming pregnant at a young
age reduce breast cancer risk.

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Risk Factors
8. Birth control:

 Studies have found that women

using oral contraceptives (birth
control pills) have a slightly
greater risk of breast cancer than
women who have never used
them.

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Risk Factors
9. Breastfeeding:

 Some studies suggest that

breastfeeding may slightly
lower breast cancer risk,
especially if breastfeeding is
continued for 1½ to 2 years.

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Sings and Symptoms:

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Investigations
 Doctors can investigate the breast
cancer by doing:

1. Mammography: The goal of

mammography is the early
detection of breast cancer.

2. Breast ultrasound.

3. Magnetic resonance imaging mammogram

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Investigations
4. Breast Biopsy:

 A breast biopsy is a small needle

sample of tissue taken from your
breast.

 Several samples may be taken and

sent to a laboratory for testing to find
out if the lump is cancerous or not.

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Treatment
 The treatment of breast
cancer has certain steps:

1. Surgery.

2. Chemotherapy.

3. Radiotherapy

4. Hormonal therapy

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Treatment Cont..
1. Surgery:

 The first step and most common

form of treatment for breast
cancer is surgery.

 Surgery involves removing the

tumor and nearby margins.

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Treatment Cont..
 There are certain procedures in
surgery:

1. Lumpectomy: removal of
cancerous tumor without
removing the entire breast.

2. mastectomy: removal of the

entire breast.

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 Total mastectomy
lumpectomy

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Treatment Cont..
2. Chemotherapy : is a breast
cancer treatment method that
uses a combination of drugs
to either destroy cancer cells
or slow down the growth of
cancer cells.

3. Radiotherapy: uses high-

energy rays to kill cancer
cells.

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Treatment Cont..
4. Hormonal therapy:

 If the cancer cells have hormone

receptors, you may be prescribed
hormone therapy drugs, such as
blockers or inhibitors.

 Both types of drugs help to

destroy cancer cells by cutting off
their supply of hormones.

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Prevention
 Breast cancer prevention begins with various
factors you can control. For example:

1. Control the weight

2. Get plenty of physical activity

3. Breast-feed.

4. Healthy diet.

5. Discontinue hormone therapy

6. Avoid exposure to environmental

pollution
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Screening
 Breast cancer screening means
checking a woman's breasts for cancer
before there are signs or symptoms of
the disease.

 Three main tests are used to screen

the breasts for cancer.

1. Mammogram.

2. Clinical breast exam. A clinical

breast exam is an examination by a
doctor or nurse

3. Breast self-exam.
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Why women are more common to have breast
cancer than men?
 there are several factors that could
explain why breast cancer is more
common in women:

1. more breast tissue in women.

2. different hormone levels: estrogen

and testosterone are present in both
men and women, but at different levels.

3. menstruation.

4. lactation.

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How we can repair the breast after
mastectomy?
 doctors can repair the breast after
mastectomy by breast
reconstruction.

 Breast reconstruction is a type of

surgery for women who have had
a breast removed (mastectomy).

 The surgery rebuilds the breast

mound so that it is about the same
size and shape as it was before.

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 Breast reconstruction

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References
 http://www.cancer.org/Cancer/BreastCancer/DetailedGuid
e/breast-cancer-what-is-breast-
cancer

 http://www.nationalbreastcancer.org

 http://www.cancer.org/cancer/breastcancer/moreinformati
on/breastreconstructionaftermastectomy/breast-reconstruct
ion-after-mastectomy-what-is-br-
recon

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 Thank You

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