breast cancer(research paper) | Breast Cancer | Mammography






TOPIC: BREAST CANCER I.Examination (BSE) B. Conclusion . Breast Self . Causes A. Breast Clock – Examination (BCE) VII. Environmental factors C. Genetic Factor B. Introduction II. Early Detection VI. Symptoms V. Breast cancer define III. Risk factors IV. Prevention A.

8th Edition. In Africa. (3. to 33. and improved cancer treatment programs. (9) Material which is of interest but not immediately applicable has been placed in smaller print.CHAPTER 1 INTRODUCTION Breast Cancer constitutes a major public health issue globally with over 1 million new cases diagnosed annually.000 in the 1980s. While mortality rates are declining in the developed world (Americas. the converse is true in the developing world as well as in eastern and central Europe.3 per 100. Breast Cancer has overtaken cervical cancer as the commonest malignancy affecting women and the incidence rates appear to be rising. and a high morbidity and mortality. preponderance of younger pre-menopausal patients. (5) These increases in incidence are due to changes in the demography. The hallmarks of the disease in Africa are patients presenting at advanced stage.4) In Nigeria for example. (3.2) There is an international/geographical variation in the incidence of Breast Cancer.(1. In the Recommendations we have followed the principles developed in the Breast Health Global Initiative. Incidence rates are higher in the developed countries than in the developing countries and Japan.000 annual deaths and about 4. Incidence rates are also higher in urban areas than in the rural areas.4 million women living with the disease. It is the commonest site specific malignancy affecting women and the most common cause of cancer mortality in women worldwide.6 per 100.000 in 2001.6) This Review is meant to provide practical guidance for the surgeon working in the developing world. (10-12) . socio-economic parameters. better reporting and awareness of the disease. screening. epidemiologic risk factors. Australia and Western Europe) as a result of early diagnosis.(6-8) Breast cancer and its treatment constitute a great physical.000 in 1992 and 116 per 100. resulting in over 400. We have relied on the Chapter on Breast Cancer by Bland et al in Schwartz’s Principles of Surgery. incidence rate has increased from 13.8–15. psychosocial and economic challenge in resource limited societies as found in Africa. lack of adequate mammography screening programs.

1 © 2000 WebMD. 1 Breast cancer is a common cancer among women in the United States and second only to skin cancer. and each one may require a different treatment. 3 Risk Factors for Breast Cancer A risk factor is something that may increase the chance of developing a disease. All rights reserved. Inc. Each may have different characteristics. can invade or destroy normal tissue. affecting about 178. This is called metastasis. The diagram shows where these body parts are within the breast.480 women in the United States in 2007. There are many different types of breast cancer.cancer causing mutations in BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2) account for 5%-10% of all breast cancer cases • Hormonal factors. 2 Most breast cancer begins in the milk ducts.STATEMENT OF THE PROBLEM What is Breast Cancer? Cancer is a general term that refers to cells that grow and multiply out of control and possibly spread to other parts of the body. Cancer cells take nutrition and space away from normal cells. These ducts connect the milk-producing glands (called lobules) to the nipple. called a tumor. The following are risk factors for developing breast cancer 4: Female gender Increasing age Personal history of breast cancer or previous breast biopsies Family history Genetic factors . Some breast cancer begins in the lobules themselves. Cancer cells can also spread to other parts of the body. later age at menopause. having no children • • • • • . Cancer can cause harm in different ways. later age at birth of first child. such as earlier age at first period. and the rest begins in other tissues. A lump of cancer cells.

What cause it? The exact cause of breast cancer is not known. about 1% of all breast cancer occurs in men.2 Family history also plays a role in the development of breast cancer. You are more likely to have breast cancer if your mother. any breast lump in an adult man is considered abnormal. Also. or mutations.1. or sister has breast cancer. 8 Many people believe that only women have breast cancer. although rare. But. women who carry certain genes called BRCA1 and BRCA2 are more likely to have breast cancer. Understanding Your Breast Cancer Pathology Report Knowing the biological makeup of the tumor helps the doctor understand how quickly any cancer might grow and what treatments may be best. father. about 1 in every 8 women who live to be 80 will have been diagnosed with breast cancer at some point in her life. If you have a strong family history of breast or ovarian cancer. Staging systems help describe the cancer. Female hormones and increasing age play a part. For this reason. so that the doctor can decide what treatments are appropriate. Most men who have breast cancer are older than 65. but it can appear in younger men. The chances that you will develop breast cancer increase as you age. Studies show that menopausal women who take hormone therapy with estrogen and progestin have an increased risk of breast cancer. Women who take estrogen alone may have a slightly increased risk. People who inherit specific changes. In the United States.7 . you may want to be tested for these genes. in one or both of these genes have a greater risk of developing breast cancer.Breast Cancer Stages A cancer's stage refers to how much the cancer has grown and where it has spread.

the disease can appear in younger men. such as scaling of the skin or a nipple that turns in. and ridging of the skin of the breast may also be present.7 Inflammatory breast cancer is a specific type of breast cancer that involves the skin of the breast. Although most men diagnosed with breast cancer are older than 65. Other symptoms of breast cancer may not appear until the cancer is more advanced. any breast lump in an adult male is considered abnormal. A change in the size or shape of the breast. such as a dimple or skin that looks like an orange peel. Some women may also develop a lump in the breast. These include: • • • A thickening in the breast or armpit. . tenderness. • • A green or bloody fluid that comes from the nipple. It occurs when breast cancer cells form "nests" and block the lymphatic drainage from the skin of the breast. But early breast cancer is often found on a mammogram before a lump can be felt. and warmth. For more information. see the topic Inflammatory Breast Cancer. • A change in the nipple. A change in the color or feel of the skin around the nipple (areola). About 1% of breast cancer occurs in men.What are the symptoms? Symptoms The first sign of breast cancer is often a painless lump. Changes in the skin of the breast. Thickening of the skin of the breast (an orange-peel appearance). Symptoms include redness. rapid breast enlargement. For this reason.

4 This includes taking hormones after menopause. the more risk you have for breast cancer. use a low dose for as short a time as possible.10 Healthy food and exercise .1.1 • Using estrogen by itself may slightly raise breast cancer Breast-feed. Having a full-term pregnancy before age 30 also lowers your breast cancer risk. high-dose hormones after menopause. If you use hormone therapy for menopause symptoms. The benefit appears to be greatest in women who breast-fed for longer than 12 months or who breast-fed several children. But you can make personal choices that lower your risk of breast cancer. your doctor may also offer you certain medical treatments that can help prevent breast cancer. risk.27 • Strive for a healthy weight.1.4 Getting regular exercise and watching what you eat can help. which raises your breast cancer risk. such as your age and being female. Experts think that the longer you have higher estrogen. Breast-feeding may lower your breast cancer risk. The years when you have a menstrual cycle are your high-estrogen years. Extra fat cells make extra estrogen.How can I prevent breast cancer? Prevention You cannot control some things that put you at risk for breast cancer. Female hormones Hormones change the way cells within the breast grow and divide. If you are at high risk for getting breast cancer. 3 This includes estrogen-progestin and estrogen- testosterone. 26 • Avoid long-term.

1. 2. It is helpful to find precisely the site for FNAC and biopsy. Mammography. a number of times.• Eat a healthy diet with plenty of fruits. and whole grains. Breast Self-Examination (BSE) once a month. vegetables. It can be done easily. 4. In post menopausal women it can be done on a fixed day of each month. usually after 50 years of age. just after the period.e. periodically. . It confirms the diagnosis of breast cancer. i. A low-fat diet with limited red meat may lower your breast cancer risk. CanScan also predicts broadly. 30 • Methods of detecting Breast Cancer 1. Biopsy: It means examination of tissue under microscope. o The tissue from the suspicious area can be achieved by various methods. It is usually done in clinic under local anaesthesia by a specially designed instrument. risk of Breast cancer. o Ultrasonography scanning is now a part of breast examination. 5. Examination by health worker/doctor. with no radiation. o It is an X-ray of the breast Screening mammography is key to early detection. This can be aided by "Can-Scan". The aspirates are spread over slides and examined under microscope for abnormal cells. i. looking for cancer in a woman who has no obvious symptom of disease. It can differentiate between cyst and solid lesion. 29. 3.e. o FNAC can be done conveniently without even local anaesthesia by a disposable syringe attached with a fine needle. o Complete steps for conducting BSE are given in CanScan. When should one do BSE? It should naturally be done when the breast is smaller in women having menstruation.28. Ultrasonography and FNAC (Fine Needle Aspiration Cytology). Recommendation for BSE Once a month for women from age 40 onwards.

prompt and standardized treatment to reduce the burden of advanced disease in African women. But incidence of cancer may be controlled by certain precautionary and prophylactic measures. Cancer screening and prophylactic drug like Tamoxifen (chemoprevention) have been proved useful in Breast Cancer. lobules. Some vaccines are helpful in prevention of some cancers. Further research is needed to understand the role of genetics and environment in the etiology of breast cancer in Africa. and with respect to its features in individual countries and cultures. Lobules end in dozens of tiny bulbs that can produce milk. RECOMMENDATIONS . Each breast has 15 to 20 sections called lobes. The lobes. and bulbs are linked by thin tubes called ducts. By the year 2020 there will be 20 million new cancer cases each year. which have many smaller sections called lobules. The breast is made up of lobes and ducts. The global incidence of cancer is soaring due to rapidly ageing population in most countries. CONCLUSION Management of breast cancer is a major challenge in resource limited countries.CHAPTER 111 Summary Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. but is still limited with respect to its etiology and biology. majority of who are worse hit in the most productive part of their life time. Avoidance of smoking will decrease tobacco related diseases. Average life expectancy will increase by 10 years in 2020 AD. Efforts should be geared towards early diagnosis. Our knowledge about breast cancer is evolving.

West African Journal of Medicine 2000 Jul. Adelusola KA. et al. Bray F. Yip CH. Adesunkanmi ARK. Breast cancer. Lancet 2005 May 14. et al. Ajayi OO. Goldhirsch A. (1012. Breast cancer in Egypt: a review of disease presentation and detection strategies. Limited. Veronesi U. Global cancer statistics. Vorobiof G. Bese NS.15(3):399-409. Breast 2006 Jun. CA: a Cancer Journal for Clinicians 2005 Mar. Parkin DM.Bland ea. These guidelines unfortunately are not applicable in countries with resource constraints as they are not economically feasible or culturally appropriate. el-Khatib O. Sitas F.19(3):179-91. Yip CH. Bray F. The severity.12(s1):S3-S15. (7) Hisham AN. Abstract Only (9) Kirby I. Ref Type: Generic (10) Anderson BO. 2005.27(2):130-3. Pisani P. Gaafar R.In high-resource countries. Breast cancer in Nigeria. Abstract Only (8) Parkin DM. Durosimi MA. Yip CH. Adebamowo CA. Khaled H. Following the Breast Health Global Initiative we have stratified the recommendations into Basic.[see comment]. [Review] [74 refs]. 2005. Shyyan R. Vorobiof DA. [Review] [44 refs]. The Breast Journal 2006. Eniu A. CA: a Cancer Journal for Clinicians 2005 Mar.138) BIBLIOGRAPHY A: BOOKS (1) Veronesi U. Schwartz's Principles of Surgery 8th edition. Vorobiof G. [Review] [160 refs]. Enhanced and Maximal.19(18 Suppl):125S-7S. [Review] [16 refs]. Abstract Only (3) Vorobiof DA. Overview of breast cancer in Malaysian women: a problem with late diagnosis. (6) Adesunkanmi AR.9(3):448-63. evidence-based guidelines outlining optimal approaches to early detection.55(2):74-108. 2007. Breast cancer incidence in South Africa. et al. Ajayi OO. Global cancer statistics. Boyle P. Asian Journal of Surgery 2004 Apr. Lawal OO. Viale G. Parkin DM. The following recommendations might be considered appropriate in the resource-poor countries of Africa. (2) Parkin DM. Smith RA. (5) Adebamowo CA. (4) Omar S. Journal of Clinical Oncology 2001 Sep 15. Orecchia R. Zekry AR. et al. Ferlay J. Lawal OO. Ferlay J.55(2):74-108. Bray F. et al. Pisani P. outcome and challenges of breast cancer in Nigeria. Breast Cancer in Limited-Resource Countries: An Overview of the Breast Health Global Initiative 2005 Guidelines. Eissa S. Sitas F. diagnosis. .365(9472):1727-41. Hisham AN. The Breast. Eastern Mediterranean Health Journal 2003 May. and treatment of breast cancer have been defined and disseminated. et al. Bray F.

Inc. Sarg MJ.cancer. Altman R. American Cancer Society Website.B: Internet Sites 1. Overview: breast cancer-what is breast cancer? Available at: http://www. Ga: American Cancer Society. 2000. Atlanta. The Cancer Dictionary-Revised many women get breast cancer? Available at: http://www. . 2. American Cancer Society. Breast Cancer Facts & Figures 2005-2006.cancer. New York. NY: Checkmark _cancer_5.asp Accessed September 2. 2005. 4.asp Accessed September 2. 2008. 3. American Cancer Society Website. Overview: breast cancer .

remember the spring” goes.ACKNOWLEDGMENT As the Chinese proverbs: “ When you drink from the stream. to my English teacher Mr.L.S . Thank you for taking care of me & for loving me always. And most of all__ to our Almighty God for making this research paper a possibility. The Researcher. I began to understand & even like myself. A. to my loving parents____ Thank you for the support that you spend to me for all my requirements in school. the Researcher would like to thank the following persons. First. Joselito Orbase___ Thank you for being you – your’e a wonderful person. Through you. Second. You were there when I needed you to confide in and ask advice from.

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