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Pathophysiology Invasive Ductal Carcinoma Breast Cancer Stage Modifiable factors: Endometriosis Long- Term use of Antiperspirant Female

, Early Menarche (11 years old), Age(53), Nulliparous, Asian

Etiology: 4 Unknown

Exposure to Parabens (chemical present in antiperspirant which is a weak estrogen-like substance

Increased Estrogen level

Toxin interfere the circulation in the lymphatic system Toxin build up in the breat

Increased Estrogen metabolism

Increased cell proliferation

Initiation phase Carcinogen binds to cell’s DNA resulting to alteration of function

Genotoxic waste in estrogen metabolism takes place

Error in cellular replication

Alteration of the tumor suppressor genes takes place DNA repair genes are altered and turned off.

Proto-oncogenes becomes oncogenes Cells divide rapidly and uncontrollably. ContinuationCancer Phase cell grows and divides rapidly. Continuous duplication of mutated DNA

no metastasis Accumulation of cancer cells The expanding mass compresses nearby blood vessels leading to necrosis. increasing pressure on surrounding structures .no involvement M.Single cell divide abnormally Stage 1 Thickening T in / Lump the breast Formation of new tissue or tumor at the right breast’s milk ducts Not detected Malignant conversion happens T.≤ 2cm N.(+) or (-) M. Cells break out of the tumor and invade surrounding nodes and blood vessels Lymphatic Spread Dissemination of the cancer cells in the lymph Stage 2 Cells penetrate and lodges in the lymph nodes and grow Hematologic Spread Dissemination in the vessels T. and area of inflammation around the metastasis Cancer moves to etracellular matrix by secreting enzymes Surrounding vessels and lymph nodes become obstructed Endothelium cracks open then causes surrounding tissue to be damaged Entry to the blood vessels .≤ 5cm N.

evident .(+) M.>5cm N.(+) (-) M . destroying epithelial cells Stage 3 Impaired lymph flow and erosion of tumor New Site of tumor Remains undetected and untreated Cancer cells continue to venous blood flow and metastasize Detected (July 2011) Medical management: Mastectomy (August 2011) Diagnostic Test:Biopsy Metastasize to the bone Medical management: Chemotherapy Poor Prognosis Organ Failure New metastasis on lungs and other organs Lymphadema Cardiac Arrest Failure of liver and lungs Death Stage 4 T.any size N .Distant metastasis Irritation and build up of fluid in adjacent tissues T.Unblocked blood vessels drain towards the venous blood flow Blockage of lymph nodes draining the fluid Inflammation of the breast and swelling of the lymph nodes Cancer cells continue to stream in the lymph fluid Cancer cells invade membrane linings Increase capillaries Invasive metastasis.