3.  Cancer occurs as a result of mutations, or
abnormal changes, in the genes responsible for
regulating the growth of cells and keeping them
healthy
 the cells in our bodies replace themselves through
an orderly process of cell growth: healthy new
cells take over as old ones die out. But over time,
mutations can ―turn on‖ certain genes and ―turn
off‖ others in a cell.
 That changed cell gains the ability to keep
dividing without control or order, producing more
cells just like it and forming a tumor.

4.  A tumor can be benign (not dangerous to health)
or malignant (has the potential to be dangerous.
 Malignant tumors are cancerous. Left
unchecked, malignant cells eventually can spread
beyond the original tumor to other parts of the
body.

5.  The term ―breast cancer‖ refers to a malignant
tumor that has developed from cells in the breast.

6.  Usually breast cancer either begins in the cells of the
lobules, which are the milk-producing glands, or the
ducts, the passages that drain milk from the lobules to
the nipple. Less commonly, breast cancer can begin in
the stromal tissues, which include the fatty and
fibrous connective tissues of the breast.
 Over time, cancer cells can invade nearby healthy
breast tissue and make their way into the underarm
lymph nodes,(lymph nodes are : small organs that filter
out foreign substances in the body).
 If cancer cells get into the lymph nodes, they then have
a pathway into other parts of the body.

8.  Stage 0 :Cancer cells remain inside the breast duct, without
invasion into normal adjacent breast tissue.
 Stage IA :The tumor measures up to 2 cm AND the cancer has
not spread outside the breast; no lymph nodes are involved.
 Stage IB :There is no tumor in the breast; instead, small groups
of cancer cells -- larger than 0.2 millimeter but not larger than 2
millimeters – are found in the lymph nodes OR there is a tumor
in the breast that is no larger than 2 centimeters, and there are
small groups of cancer cells – larger than 0.2 millimeter but not
larger than 2 millimeters – in the lymph nodes.
 Stage IIA: No tumor can be found in the breast, but cancer
cells are found in the axillary lymph nodes (the lymph nodes
under the arm)
OR the tumor measures 2 centimeters or smaller and has spread
to the axillary lymph nodes OR the tumor is larger than 2 but no
larger than 5 centimeters and has not spread to the axillary
lymph nodes.

9.  Stage IIB: The tumor is larger than 2 but no larger than 5
centimeters and has spread to the axillary lymph nodes
OR the tumor is larger than 5 centimeters but has not spread to
the axillary lymph nodes
 .Stage IIIA: No tumor is found in the breast. Cancer is found in
axillary lymph nodes that are sticking together or to other
structures, or cancer may be found in lymph nodes near the
breastbone
OR
the tumor is any size. Cancer has spread to the axillary lymph nodes,
which are sticking together or to other structures, or cancer may
be found in lymph nodes near the breastbone.

10.  Stage IIIB: The tumor may be any size and has spread to the chest wall
and/or skin of the breast
AND
may have spread to axillary lymph nodes that are clumped together or
sticking to other structures, or cancer may have spread to lymph nodes near
the breastbone.
 Stage IIIC: There may either be no sign of cancer in the breast or a tumor
may be any size and may have spread to the chest wall and/or the skin of the
breast
AND
the cancer has spread to lymph nodes either above or below the collarbone
AND
the cancer may have spread to axillary lymph nodes or to lymph nodes near
the breastbone.
 Stage IV: The cancer has spread — or metastasized — to other parts of the
body.

11.  A ―risk factor‖ is anything that increases
your risk of developing breast cancer. Many
of the most important risk factors for
breast cancer are beyond your control,
such as age, family history, and medical
history. However, there are some risk
factors you can control, such as weight,
physical activity, and alcohol consumption.

12.  Being overweight is associated with
increased risk of breast cancer, especially for
women after menopause. Fat tissue is the
Weight
body‘s main source of estrogen after
menopause, when the ovaries stop producing
the hormone. Having more fat tissue means
having higher estrogen levels, which can
increase breast cancer risk.
 studies show that eating a lot of red
and/or processed meats is associated
with a higher risk of breast cancer. A
Diet.
low-fat diet rich in fruits and vegetables
is generally recommended.

13.  Evidence is growing that exercise can
reduce breast cancer risk. The American
Cancer Society recommends engaging in
Exercise 45-60 minutes of physical exercise 5 or
more days a week.
 Alcohol can limit your liver‘s ability to
Alcohol consumption
control blood levels of the hormone
estrogen, which in turn can increase risk

14.  Gender. Being a woman is the most significant risk factor for
developing breast cancer. Although men can get breast
cancer, too, women‘s breast cells are constantly changing and
growing, mainly due to the activity of the female hormones
estrogen and progesterone. This activity puts them at much greater
risk for breast cancer.
 Age. Simply growing older is the second biggest risk factor for
breast cancer. From age 30 to 39, the risk is 1 in 233, or .43%. That
jumps to 1 in 27, or almost 4%, by the time you are in your 60s.

15.  Race. White women are slightly more likely to develop breast cancer
than are African American women. Asian, Hispanic, and Native
American women have a lower risk of developing and dying from
breast cancer.
 Pregnancy and breastfeeding. Pregnancy and breastfeeding reduce
the overall number of menstrual cycles in a woman‘s lifetime, and
this appears to reduce future breast cancer risk
 Family history of breast cancer. If you have a first-degree relative
(mother, daughter, sister) who has had breast cancer, or you have
multiple relatives affected by breast or ovarian
 Radiation therapy to the chest. Having radiation therapy to the
chest area as a child or young adult as treatment for another
cancer significantly increases breast cancer risk. The increase in
risk seems to be highest if the radiation was given while the breasts
were still developing (during the teen years).

16.  High levels of estrogen (due to cirrhosis of the
liver, for example) or estrogen-related drugs
(such as for prostate cancer)
 Exposure to radiation
 Over age 60
 High alcohol consumption
 Obesity
 Inherited gene mutations
 Family history of breast cancer

17.  Treatment plans for breast cancer
are developed based on a several
factors.
1- The type and stage of the cancer,
2-the sensitivity of the cancer to
certain hormones
3-the medical history of the patient

18.  The World Health Organisation [WHO] related that two
components of early detection have been shown to
improve cancer mortality:
1- Education, which in turn helps people
recognize early signs of cancer and seek
prompt medical attention for symptoms.
2-Screening programs, which are a great tool
in helping identify early cancer or pre-
cancer before signs are recognizable,
including mammography for breast cancer.

19. › Primary Treatments
 Lumpectomy
During a lumpectomy, the surgeon remove the tumor and a small
margin around it. A lumpectomy is usually effective on small
tumors. This way they can be removed without involving too much
surrounding tissue.
 Mastectomy
1- A simple mastectomy (also called ―partial mastectomy) involves
removing all of the breast tissue. That includes skin, fatty
tissue, lobules, and ducts
2- A radical mastectomy (also called ―total mastectomy‖) also removes
the chest wall muscles and the surrounding lymph nodes in the
armpit.

20.  Adjuvant Therapy Treatment
 Neoadjuvant therapy treatments are used before
surgery to shrink large tumors and make the surgery
easier.
 Adjuvant therapy treatments are applied after the
surgery to help with recovery. Both are intended to
increase long-term, disease-free survival rates. These
therapies may include:
Biological or targeted therapy
Chemotherapy
Hormone therapy
Radiation, a local adjuvant therapy

21.  Planning Your Treatment
 Chemotherapy.
 Radiation Therapy
 Hormonal Therapy
 Therapies
 .Complementary & Holistic Medicine
 Drugs for Treatment and Risk Reduction

22. http://www.nationalbreastcancer.org/nbc
A program for early education

f-programs/beyond-the-shock
about breast cancer  Beyond the shock is a program with all
the information you need about breast
cancer
 http://www.nationalbreastcancer.o
rg/nbcf-programs/breast-cancer-
Make your plan
edp
 Make the early detection plan
helping people how to diagnose the
case themselves

23.  One in eight women will be diagnosed with breast
cancer in their lifetime.
 Breast cancer is the most commonly diagnosed
cancer in women.
 Breast cancer is the second leading cause of death
among women.
 Each year it is estimated that over 220,000 women in
the United States will be diagnosed with breast
cancer and more than 40,000 will die.
 Although breast cancer in men is rare, an estimated
2,150 men will be diagnosed with breast cancer and
approximately 410 will die each year.

24.  Mammography is the process of using low-
energy-X-rays to examine the human breast
and is used as a diagnostic and a screening
tool. The goal of mammography is the early
detection of breast cancer, typically
through detection of characteristic masses
and/or microcalcifications.

25. ―Cancer can take my breast and rob me
of a summer but it can't take my spirit.
I've learned that no matter how bad
life gets, I am the only one who can
control my attitude and I will not let
cancer take that away from me.‖
 Katie Adams . A T,A in university of Ottawa
 What was your diagnosis? Stage 2 Breast Cancer
 How did you find out you were sick? What led to your diagnosis?
 I found a lump and told my doctor about it. From there, there was a
lot of imaging done but because of my age, it was assumed that I
did not have cancer. Two months before my diagnosis, I was
told, ―You don't have cancer‖ by a surgeon. Finally, seven months
after telling my doctor about my lump, a biopsy was done and it
came back positive.

26.  What was the toughest part of your challenge?
 Chemo was pretty tough but I think the transition between
treatment and finding your ―new normal‖ has been the hardest for
me. I think a lot of time people assume that when you're done
treatment, you're done cancer and if you've ever had cancer, you
know that is not the case. I'm trying to get back to the life I knew
but trying to incorporate cancer into that life.
 What really motivated you to keep going while you were sick?
 I knew that other women needed to be helped so I knew if I was
strong, it would give other women strength. I also had such a
fantastic support system that picked me up when I was down and it
made it easier to be strong when so many people believed in me.
 What are your thoughts and feelings about your illness now? How
have they changed since before your diagnosis?
 I realize now that having cancer isn't a death sentence and as I
mentioned before, you become an expert about (in my case) breast
cancer. I knew virtually nothing compared to what I know now.
Now, when I hear ―breast cancer‖ I have a physical reaction to it.
Rather than just hearing the words, I feel the pain.

27.  What year was it? What was your age at the time? 2011/26
 What were your first thoughts when diagnosed?
 Disbelief, I thought they had the wrong file. I was obviously numb
for a few days, too.
 What did your treatment consist of?
 I had two surgeries (a mastectomy and nine months later, I had the
second part of my reconstruction) and six rounds of chemo. Now I
am on a hormone inhibitor for the next five years that will slow the
growth of cancer if there were any cells that survived surgery and
chemo.

28. ‗I was losing my hair because of the chemo and that affected me greatly. One day I decided
that I was going to take control and I totally shaved my head. It‘s a difficult thing to
explain, but it felt like I was taking control for once.
Andrew Hartling
 How did you find out you were sick? What led to the diagnosis?
 I noticed a small bump under my right nipple. Being a typical man, I
ignored it for a while but ended up seeing my family doctor in
December 2010. I was told it was probably nothing but I should
have some tests done to make sure. I was sent for an ultrasound
and a mammogram. Being a man and being sent for a mammogram is
quite an experience. The results came back and I was told they still
weren‘t quite sure so I was scheduled for a biopsy. It was about a
week later the doctor called me and told me my diagnosis was
Invasive Ductal Carcinoma. I was very confused about what I was
being told and I had to ask him to confirm if that meant I had
cancer. He was very sympatric as he explained to me I had breast
cancer. I was at a loss for words and simply thanked the doctor and
hung up on him.

29.  What were your first thoughts when diagnosed?
 I was very scared and confused. My first instinct was that I needed
information and I researched the Internet. There really wasn‘t a lot
of information on men‘s breast cancer, but I did find an
inspirational story of a gentleman from England who fought breast
cancer and completely recovered. I have read his story at least 100
times.
 What is your current medical status?
 I am currently cancer-free but undergoing chemo and radiation
treatments as a precaution to prevent reoccurrence.
 What is the toughest part of your challenge?
 The toughest part is putting my life on hold for so long. There are
so many things that have changed in the last months and it is
overwhelming sometimes.
 What are your thoughts and feelings about your illness now? How
have they changed since before your diagnosis?
 It‘s hard to explain but I was so secretive and private about my
diagnosis for the first months. I didn‘t tell anyone I had cancer,
much less breast cancer. People around me knew I something was
going on but only my closest circle of friends knew the truth. It‘s
been five months now since my first diagnosis and my attitude has
changed. I want to talk about what is happening to me and ask for
help when I need it.It took me quite a while to figure out that I
couldn‘t fight cancer by myself.

30.  Common Misconception
 Eating fatty foods causes breast cancer.
 Reality Check!
 Research studies have not been able to prove that there is clearly a direct
correlation between the fat content in food and the dangerous factors
that lead to all forms of Breast Cancer, however it has been proven to be a
risk factor increasing the chances of Breast Cancer in post-menopausal
women.
 Common Misconception
 Breast cancer is a fatal disease that kills all patients.
 Reality Check!
 There has been a noticeable increase in the number of women diagnosed
with Breast Cancer each year, but the mortality rate is significantly
decreasing. Some reasons for this phenomenon comprise the enhanced
availability and nature of resources for treatment and early detection of
tumors through both Breast Self-examination and various technologies
including X-Ray Mammography.

31.  Common Misconception
 Breast Cancer is a contagious disease since it can occur in families with
many members affected over time or many women can be diagnosed in single
communities at the same time.
 Reality Check!
 Breast Cancer is not passed from person to person like an infectious
disease. Contagiousness has nothing to do with genetic mutations or
inheritance patterns of disease
 Common Misconception
 Finding an unnatural lump on the breasts means that a woman has Breast
Cancer.
 Reality Check!
 While you are undergoing a Breast-Self-examination if unnatural lumps,
infections, or any irregularities are detected, you should immediately
consult a specialist doctor. It is possible that detected irregularities are not
cancerous, however it is only a specialist doctor that can identify and
determine its nature..
 Common Misconception
 Breast cancer is a disease that is only found in women and not in men.
 Reality Check!
 Statistics in the United States of America have proven that women are only
more susceptible to the disease than men, where for every 135 cases of
Breast Cancer in women, one man is diagnosed. Men should also take a
proactive approach to their Breast health to encourage early detection and
curability if irregularities are present

32.  BREAST SELF-EXAMINATION
What am I looking for when I do a breast self-exam?
You are looking for a lump or change that stands out as
different from the rest of your breast tissue. If you discover a
lump or other change in your breast, either during breast self
examination or by chance, you should examine the other breast.
If both breasts feel the same, the lumpiness is probably normal.

33. . How often should I do a self-exam?
A breast self-exam is recommended every month a few days after
your period ends. During this time, your breasts are less tender or
swollen. It is important to do your breast self-exam at the same
time during your menstrual cycle.

34. MAMMOGRAM
What is a mammogramph and why should I have one?
the process of using low-energy-X-rays to examine the human breast
and is used as a diagnostic and a screening tool. The goal of
mammography is the early detection of breast cancer, typically
through detection of characteristic masses and/or
microcalcifications
You simply stand in front of an x-ray machine. Your breast is placed
between two plastic plates to flatten it. This helps in getting a more
clear picture and subsequently a more accurate diagnosis. A
mammogram takes only a few seconds.

35. A small group of 24 founding members, Egyptians and expatriates
concerned with the high incidence of breast cancer and the lack
of related support services in. they are a driving force to bring
breast cancer awareness, education, and services to Egyptian
women.
BCFE Goals:
 1. Build a culturally sensitive physical and emotional support system
to enhance the quality of life for women with breast cancer and
their families.
 2. Collect a body of statistics to support research and promote
enlightened care.
 3. Facilitate access to affordable and high quality professional
diagnostic treatment, and rehabilitative services for women in all
economic strata.
 4. Educate the public about breast cancer, the importance of early
detection, and eradicate the stigma attached to having breast
cancer.
33 Kasr El Aini Street, Suite 25, Floor 7, Fom El Khalig- Cairo 1141
Tel: (202) 23682 431/2
Mobile: 010 3491104