breast cancer Flashcards
what’re the most common symptoms of the breast cancer ?
its asymptomatic.
pain or discomfort isn’t usually a symptoms of the breast cancer
how to general approach to pt with breast cancer ?
by the triple assessment
- clinical presentation (history)
- clinical examination
- imaging
whats the triple assessment ?
@history
- pt with breast cancer is usually with breast cancer is asymptomatic .largrer cancer may don’t have any pain > because the pain and discomfort is not the symptoms of the breast cancer .only 5%-10% of pt with cancer have pain
- but mainly we search for the the family history of the breast cancer in the 1st degree relative
examine the pt first in siting position and the arm is relax and then exam them in laying position when their arms are raised :
- check any change in the size and shape
- any skin changes as tethering or laceration or lesion
- any nipple inversion , change in the skin changes
- any nipple discharge
- any axillary LN changes
after that to complete the examination we should examine the chest , abdomen and the neurology
chest —
a) breathing abnormality
b) bone pain
c) hypercalciemia
abdomen —
a) abdominal pain
b) jaundice
neurology —-
a) headache
b) neurological sign
c) altered cognitive function
the concerning findings are : 1- lump or change in the shape , the size and the counter 2-skin tethering 3- laceration 4-dilated vein 5-nipple inversion 6- mammy Paget disease 7-edema or peau d'Orange
usually mammography, ultrasound and needle biopsy
what’re the clinical presentation of the breast cancer ?
1- painless lump
2- painful lump
3-skin ulceration and fungation
4-nipple discharge
5- axillary lymph nod enlargement
6- secondaries to the liver overies
7- chest pain and heamoptsis
8- bone pain and pathological fracture
9- plural effusion , ascites
what’re the cutaneous manifestation of the breast cancer
1- skin ulceration and fungation 2-ulceration and nipple discharge 3- nipple retraction -------------------------- 4-tethering of the skin 5- dimpling of the skin 6- peau d' orange --------------------------- 7- cancer en cuirasse
what’re the concerning findings in the physical examination ?
the concerning findings are : 1- lump or change in the shape , the size and the counter 2-skin tethering 3- laceration 4-dilated vein 5-nipple inversion 6- mammy Paget disease 7-edema or peau d'Orange
whats the cause of the peau d’ orange ?
the dermal lymphatic is obstructed and so the sebaceous gland and the hair follicle is buried تدفن giving raise as orange
whats the cause of the skin dimpling ?
cancer vinlterate into the cooper ligament
whats the cause of the nipple retraction as circumferential ?
infiltration to the lacterferious duct
whats the cancer en cuirasse ?
its that the breast cancer metastasis to the skin and appear nodular as armor coat
what dose the local spread of the tumer means ?
its spread to the skin ,pectorals muscle and the chest
what dose the lymphatic spread means ?
spread to the internal mammary gland & axilla
in advance stage its spread to the supraclavicaular LN or contalateral side
for where the tumer goes ?
it metastasis to the lumber vertebrae ribs and skull
and liver lung and ovary arenal gland
whats non invasive breast carcinoma?
ductal carcinoma in situ
lobular carcinoma in situ
paget’s disease
the non invasive only 10%
how the ductal carcinoma is seen in mammogram ? and whats the chance of recurrence ?
its seen in the mammogram as microcalcification
after 5 years reccurance (25-50%)
