Kelompok 4

Breast Cancer
Kelompok 4
Marturia Drifany (18700004)
Ni Made Ary Nugraheni Ahaditama (18700040)
INTRODUCTION
Uncontrolled proliferation of cells which starts in breast cells

and attains malignancy is called breast cancer. Survey has
shown that breast cancer contributes 11 percent among all
types of cancer diagnosed globally annually and it is a major
cause of death in women. Breast cancer mainly originates
from the milking ducts or the lobules responsible for milk
supply towards ducts. Depending upon the origination breast
cancers may be ductal or lobular carcinomas
Majeed, W., Aslam, B., Javed, I., Khaliq, T., Muhammad, F., Ali, A. and Raza, A. (2014). Breast
Cancer: Major Risk Factors and Recent Developments in Treatment. Asian Pacific Journal of
Cancer Prevention, Volume 15, Nomor 8
ANATOMY OF THE BREAST
The breast is made up of fatty tissue called

adipose tissue. The female’s breasts usually
contain more glandular tissue than that of
the males. Female breasts contain 12–20
lobes which are further divided into smaller
lobules . These lobes and lobules are
connected via milk ducts. The adipose
tissue of the breast is supplied by a network
of nerves, blood vessels, lymph vessels,
lymph nodes, and is also composed of
fibrous connective tissue and ligaments.
Akram, M., Iqbal, M., Daniyal, M. and Khan, A.U. (2017). Awareness and current knowledge of
breast cancer. Biological Research, Volume 50, Nomor 1.
DEFINITION
Breast cancer is the abnormal growth of the cells

lining the breast ducts or lobules. These
abnormal cells have the potential to spread to
other parts of the body. Most breast cancers are
found when they are invasive. This means the
cancer has spread from the breast ducts or
lobules into the surrounding breast tissue.
Invasive breast cancer can be early, locally
advanced or advanced (metastatic).
Cancer Council Australia. Understanding Breast Cancer. (Grove C, ed.). Sydney; 2016.
EPIDEMOLOGY
Currently, one in twelve females in Britain between age of 1 and 85 years gets
breast cancer. With one million new cases of cancers reported in the World, breast
cancer is common in females and comprises 18% of all women cancer. Incidence of
breast cancer is predicted to increase to 85 per 100,000 women by 2021. In 2012,
1.67 million new cases of breast cancer were diagnosed that is 25% of all cancers
among women. Breast cancer is found mostly in highly populated areas of South
Asian developing counties.
Pathophysiology
Breast tumors usually start from the
ductal hyperproliferation, and then
develop into benign tumors or even
metastatic carcinomas after constantly
stimulation by various carcinogenic
factors. Tumor microenvironments such
as the stromal influences or
macrophages play vital roles in breast
cancer initiation and progression. Breast
cancer develops due to DNA damage
and genetic mutations that can be
influenced by exposure to estrogen.
Sometimes there will be an inheritance
of DNA defects or pro-cancerous genes
like BRCA1 and BRCA2
RISK FACTORS
Aging
aging is one of the most important risk factors of
breast cancer, because the incidence of breast cancer
is highly related to the increasing age. Therefore, it is
necessary to have a mammography screening ahead
of time in women aged 40 or older
Family
History
Nearly a quarter of all breast cancer cases are related
to family history. Women, whose mother or sister has
a breast cancer, are prone to this disease.
Sun, Y.-S., Zhao, Z., Yang, Z.-N., Xu, F., Lu, H.-J., Zhu, Z.-Y., Shi, W., Jiang, J., Yao, P.-P. and Zhu, H.-P.
(2017). Risk Factors and Preventions of Breast Cancer. International Journal of Biological Sciences, 13(11),
pp.1387–1397.
RISK FACTORS
Reproductive Factors
Reproductive factors such as early menarche, late

menopause, late age at first pregnancy and low parity
can increase the breast cancer risk.
Estrogen
Both endogenous and exogenous estrogens are
associated with the risk of breast cancer. The
endogenous estrogen is usually produced by the ovary
in premenopausal women and ovariectomy can
reduce the risk of breast cancer.
pp.1387–1397.
RISK FACTORS
Family History
Reproductive factors such as early menarche, late

menopause, late age at first pregnancy and low parity
can increase the breast cancer risk.
pp.1387–1397.
SIGN AND SYMPTOM
Breast lump
Breast lump was the most common symptom, recorded in about four-
fifths of all women (83%). The next most commonly reported presenting
symptoms were nipple abnormalities (7%), breast pain (6%), and breast
skin abnormalities (2%). The classic symptom for breast
cancer is a lump found in the breast or armpit.
Nipple retraction
Features of breast cancer generally known are such as pain in nipple,
persistent breast tenderness, discomfort or unusual breast pain, bloody
or clear nipple discharge, scaly or pitted skin on nipple, lump mass or
swelling of the breast, swelling in the armpit lymph nodes, inverted
retracted nipple, scaly or pitted skin on nipple
Koo, M.M., von Wagner, C., Abel, G.A., McPhail, S., Rubin, G.P. and Lyratzopoulos, G. (2017). Typical and atypical
presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit
of cancer diagnosis. Cancer Epidemiology, Volume 48.
SIGN AND SYMPTOM
Change in breast shape

a situation whereby the nipple retract goes in and doesn’t return to its
normal shape can be as a result of breast cancer
Breast pain
In a situation where the pain occurs in one breast, armpit or off-cycle, it
is advisable to get checked. keeping a good menstrual cycle record
might help to understand changes in the hormone in the breast and will
be useful for doctors in diagnosing what is wrong in the body
Koo, M.M., von Wagner, C., Abel, G.A., McPhail, S., Rubin, G.P. and Lyratzopoulos, G. (2017). Typical and atypical
presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a national audit
of cancer diagnosis. Cancer Epidemiology, Volume 48.
CLASSIFICATIONS AND STAGES OF BREAST CANCER
Invasive
Non-invasive (or Invasive or Ductal Metastatic
in situ) breast infiltrating breast Carcinoma breast cancer
cancer cancer
Invasive breast cancers IDC is the(IDC)
most common
As one of the most Metastases from
have cancer cells that type of breast cancer with
common types of breast cancers can be
invade and spread about 80% of all breast
breast cancer, DCIS found in lymph nodes
outside of the normal cancers. classification
is a non-invasive or in the armpit, and/or in
breast lobules and ducts, includes several subtypes:
pre-invasive breast distant sites such as
growing into the tubular carcinoma of the
cancer. the lung, liver, bone
surrounding breast breast, medullary carcinoma
and brain.
stromal tissue. of the breast, etc.
Feng, Y., Spezia, M., Huang, S., Yuan, C., Zeng, Z., Zhang, L., Ji, X., Liu, W., Huang, B., Luo, W., Liu, B., Lei, Y., Du, S.,
Vuppalapati, A., Luu, H.H., Haydon, R.C., He, T.-C. and Ren, G. (2018). Breast cancer development and progression: Risk
factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. Genes & Diseases, Volume 5
STAGES OF BREAST CANCER
Stadium 0
This is the non invasive stage of tumour which indicates that both cancerous and non cancerous cells are
within the boundaries of that part of the breast in which the tumor begins to grow and no evidence found of
their invasion in the surrounding tissues of that part, the example of this tumour stage is ductal cell carcinoma
in situ (DCIS)
Stadium 1
This stage describes as the invasive breast carcinoma and microscopic invasion is possible in this stage. It
has two categories that are 1A and 1B stage. Te category 1A describes the tumor which measures up to 2
cm and none of the lymph nodes are involved in it while stage 1B describes that small group of cancer cells
larger than 0.2 mm founds in lymph node.
Stadium 2
Stage 2 also has two categories 2A and 2B. Stage 2A describes that the tumour is found in axillary lymph
nodes or in sentinel lymph nodes but no tumor found in breast. Te tumor can be smaller or larger than 2 cm
but not more than 5 cm. However stage 2B describes that the tumor could be larger than 5 cm but can’t reach
to the axillary lymph nodes.
Stadium 3
It has been divided into three sub categories that are 3A, 3B and 3C. Amongst which stage 3A describes that
no tumor is found in breast but it can be found in 4–9 axillary lymph nodes or in sentinel lymph nodes while
stage 3B describes that the tumour can be of any size but have caused swelling or ulcer on the skin of the
breast and can have spread up to 9 axillary lymph nodes or to sentinel lymph nodes stage 3B can be
considered as infammatory breast cancer which includes red, warm and swollen skin of the breast. However
stage 3C describes the spread of tumor up to 10 or more than 10 axillary lymph nodes and it also have
involved the lymph nodes above and below the clavicle.
Stadium 4
This is the advanced and metastatic stage of cancer and this stage describes the spread to other organs of
the body that is lungs, bones, liver brain etc.
SCREENING & DIAGNOSTIC IMAGING BREAST CANCER
Mammography
Breast self-and
One of the most important
clinical breast advances in the treatment of
examination breast cancer is early
detection of non-palpable
Most clinicians encourage masses. experimental group.
women to perform monthly Diagnostic mammograms are
BSE to become familiar with performed in women who have
their normal anatomy and a palpable mass or other
empower them with regards to symptom of breast disease, a
their own healthcare history of breast cancer within
the preceding 5 years, or have
been recalled for additional
imaging from an abnormal
screening mammogram
Shah, R. (2014). Pathogenesis, prevention, diagnosis and treatment of breast cancer. World
Journal of Clinical Oncology, Volume 5, Nomor 3.
SCREENING & DIAGNOSTIC IMAGING BREAST CANCER
MRI Ultrasound
MRI is a power ful imaging
tool that produces high The current indications for
resolution images without breast ultrasonography include
requiring the application of palpable findings (including as
harmful radiation. Breast MRI the initial imaging test of
has become an integral part palpable findings in patients
of breast cancer diagnosis who are younger than 30
and management in selected years, pregnant, or lactating).
patients
Shah, R. (2014). Pathogenesis, prevention, diagnosis and treatment of breast cancer. World
Journal of Clinical Oncology, Volume 5, Nomor 3.
MANAGEMENT
1. Surgery
Surgical options for breast cancer include breast conservation surgery and mastectomy. The
extent of the surgery is dependent upon the number of tumors within the breast tissue, stage
and grade of the cancer, and patient preference. Breast conservation surgeries include
lumpectomy, mastectomy, and quadrantectomy, which require removal of the tumor but with
preservation of the majority of the normal breast tissue
a. Lumpectomy
Lumpectomy is a surgery to remove
cancerous breast tissue along with a
rim of normal tissue surrounding it
called a surgical margin
Akram, M., Iqbal, M., Daniyal, M. and Khan, A.U. (2017). Awareness and current knowledge of breast cancer.
Biological Research, Volume 50, Nomor 1.
b. Mastectomy
A mastectomy is an operation to remove a breast. It's
used to treat breast cancer in women and breast cancer
in men. The operation takes about 90 minutes, and
most people go home the following day. It can take 4
to 6 weeks to recover from a mastectomy
c. Quadrantectomy
Listen to pronunciation. (KWAD-ran-TEK-toh-mee)
An operation to remove the cancer and some normal
tissue around it, but not the breast itself. Some lymph
nodes under the arm may be removed for biopsy
MANAGEMENT
2. Reconstructive
surgery
Females who have a mastectomy
might as well have breast
renovation, either immediate
reconstruction or delayed
reconstruction. It is performed to get
better the look of the breast
following tumor surgery. All females
having a mastectomy must be
presented the option to converse
reconstructive surgical treatment
MANAGEMENT
3. Radiation therapy
It is useful for reducing the necessity
of mastectomies. A combination of a
lumpectomy and radiation therapy is
being increasingly used over a
mastectomy in the early stages of
breast cancer. High energy rays from
radiation therapy kill cancer cells.
This therapy afects only the cells
that are treated. Use of radiation
therapy may be done after breast
cancer surgery to destroy the
remaining cells in the chest area
MANAGEMENT
4. Chemotherapy
The process of killing cancer cells
by using certain medicines is termed
as chemotherapy. It can be given in
both situations, before and after
surgery, depending upon the
condition of the patient..
THANKYOU
DAFTAR PUSTAKA
Cancer Council Australia. Understanding Breast Cancer. (Grove C, ed.). Sydney; 2016.
Feng, Y., Spezia, M., Huang, S., Yuan, C., Zeng, Z., Zhang, L., Ji, X., Liu, W., Huang, B., Luo, W., Liu, B., Lei, Y.,
Du, S., Vuppalapati, A., Luu, H.H., Haydon, R.C., He, T.-C. and Ren, G. (2018). Breast cancer development and
progression: Risk factors, cancer stem cells, signaling pathways, genomics, and molecular pathogenesis. Genes
& Diseases, Volume 5
Majeed, W., Aslam, B., Javed, I., Khaliq, T., Muhammad, F., Ali, A. and Raza, A. (2014). Breast Cancer: Major
Risk Factors and Recent Developments in Treatment. Asian Pacific Journal of Cancer Prevention, Volume 15,
Nomor 8
Shah, R. (2014). Pathogenesis, prevention, diagnosis and treatment of breast cancer. World Journal of Clinical
Oncology, Volume 5, Nomor 3.
Sun, Y.-S., Zhao, Z., Yang, Z.-N., Xu, F., Lu, H.-J., Zhu, Z.-Y., Shi, W., Jiang, J., Yao, P.-P. and Zhu, H.-P. (2017).
Risk Factors and Preventions of Breast Cancer. International Journal of Biological Sciences, 13(11), pp.1387–
1397.
DAFTAR PUSTAKA
Smoot, B., Wampler, M.A. and Topp, K. (2009). Breast cancer treatment and complications. Rehabilitation
Oncology, Vol. 27, No. 3
Koo, M.M., von Wagner, C., Abel, G.A., McPhail, S., Rubin, G.P. and Lyratzopoulos, G. (2017). Typical and
atypical presenting symptoms of breast cancer and their associations with diagnostic intervals: Evidence from a
national audit of cancer diagnosis. Cancer Epidemiology, Volume 48.
Waks, A.G. and Winer, E.P. (2019). Breast Cancer Treatment. JAMA, Volume 321, Nomor 3
‌
Ebosetale Ikhuoria and Bach, C. (2018). Introduction to Breast Carcinogenesis – Symptoms, Risks factors,
Treatment and Management. European Journal of Engineering Research and Science Vol. 3, No. 7,
Moran, B., Hollingshead, J. and Farquharson, M. (2016). Farquharson’s textbook of operative general surgery.
[online] Boca Raton: Taylor & Francis
‌.

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Kelompok 4

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Breast Cancer

Uncontrolled proliferation of cells which starts in breast cells

The breast is made up of fatty tissue called

Breast cancer is the abnormal growth of the cells

Reproductive factors such as early menarche, late

Reproductive factors such as early menarche, late

Change in breast shape

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