this power point deal with breast lumps benign and malignant one .. it is talk about how to deal with patient have alump in here breast in detail from history to risk fectors .. investigation and management and also deal with awareness to breast cancer .. hope to be useful .. enjoy:)

1. Presented by:
Yusor Jaafar
Mariam Talal
Sherin Raad

2. Management of breast lump with awareness to
breast carcinom
 Introduction.
 Evaluation of breast lump.
By:
Yusor Jaafar

3. Introduction
The complaining of breast lump ranging frm 40_70%

4. Evaluation of breast lump
Diagnosis
History and
examination
imaging
Cytology
and
histology

5. History taking

7. Physical examination
 General examination
 Position

8. Inspection

9. Palpation

11. Primary analysis
 Painless lump:
Carcinoma
Cyst
Fibroadenoma
Area of fibroadenosis

12.  Painful lump:
An area of fibroadenosis
Cyst
Periductal mastitis
Abscess
Carcenoma

13. Nipple changes
 Destruction
 Depression
 Discolouration
 Displacement
 Deviation
 Discharge
 Duplication

14. Nipple discharge
 Red (blood)
 Pink (serum+blood)
 Clear pale yellow
 Brown
 Green
 Black
 Creamy white or yellow
 Thin white

15.  Nipple discharge
Duct ectasia
Intraduct papilloma
Ductal carcinoma in-situ
Associated with cyst

16. Imagimg
 Mammograpgy
Used for screening in women >40 years of age
 Computer aided detection and diagnosis(CAD)
Use computer for better visualization of lump
 3D mamography
The machine move in an arc around the breast to give 3 dimention
picture

18. BI-RADS system categories:

19. MRI
can diffrentiate between scar tissue and recurrent lesion
can be used in women with implant
know used for screnning
Ultrasound
Can diffrentiate between solid and cystic lesions
Used for guided aspiration

20.  Ductoscopy
To visulization of duct and take biopsy from abnormal areas
 Ductogram
Inject a contrast material through the tube inserted in the duct and
see the lining of the duct
 Diffuse optical tomography
Detect the percentage of HB saturation during take full inspiration
 Positron emission mammography
Use sugar attach to radioactive materials to detect malignant calls

21. Nuclear medicine study
 Scintimammography
Use radioactive tracer which is accumulate in the tissue and emmit gamma rays
which is detected by gamma camera
 Thermpgraphy
Have high failure rate .. Detect 1 from 4 malignant masses
Other experimental imiging
 Optical imiging
Pass light through breat tissue and measure the light which is pass or return
through the tissue
 Molecular breast imaging
New nuclear medicine imaging technique

22. Cytology and histology

23.  Core needle biopsy
To diffrentiate between ca in situ and invasive ca
 Fine needle diopsy
Less invasive but have high failure rate
 Vacuum biopsy
For removal of microcalcifications

25. Pathological classification of breast
lumps
Epithelial:
Duct papilloma
Connective tissue:
Neurofibroma
Lipoma
Mixed:
Fibroadenoma
Phyllodes tumor
Benign
Invasive duct
carcinoma
Inflammatory
carcinoma
Malignant

27. Benign breast lumps
•Others
•Inflammation
•Infection
•Pregnency
related
•Injury
Hematoma
Fat necrosis
Galactocele
Puerperal
abscess
Breast cyst
Fibroadenom
a of breast
Acute
bacterial
mastitis
Duct ectasia
tuberculosis
http://www.healthplus24.com/womens-health/breast-cancer/breast-lump.aspx

28. Breast Cyst
 Smooth, unilateral mass
 Feels like a cyst
 Infrequently associated
with malignancy
 Aspirate
 Watch for reforming of
cyst
 Recurring cysts are more
worrisome.

29. Galactocele
 Milk-filled cyst
 Usually follows lactation
 Firm, tender mass
 Usually in upper quadrants
 Diagnostic aspiration often curative

30. Galactocele

31. Galactocele

32. Fibroadenomas
 Causes
 Types
 Treatment

33. Fat Necrosis
 Symptoms
 Causes
 Treatment

34. Lipoma

35. Fibrocystic breasts
Aberrations of normal development and
involution (ANDI)
 Symptoms
 Causes
 Complications
 Treatment

36. Fibrocystic breasts
Aberrations of normal development and
involution (ANDI)
Clinical features:
 It most commonly affect women between (30-
50) years of age.
 The symptoms of ANDI include an area of
lumpiness and/or breast pain (mastalgia).
 The changes may be cyclical, with an increase in
both lumpiness, and often tenderness, before a
menstrual period.
 No consistent association between fibrocystic
complex and breast cancer.

37. Fibrocystic breasts
Aberrations of normal development and
involution (ANDI)

38. Mastitis
 Types
 Symptoms
 Breast abscess
Causes
Treatment
Risk factors
Weaning

39. Tuberculosis of the breast
Tuberculosis of the breast
with secondary suppurating
axillary lymph nodes

40. Breast Cancer
 Epidemology

41. Risk factors
Age
Previous
history of
breast
disease
Previous
history
of breast
cancer
Family
history
of
breast
cancer
lifestyle genetics
http://www.medscape.com/viewarticle/443381_13

42. Signs and symptoms

43. Clinical presentation
 breast cancer commences most frequently in
the upper, outer quadrant

44. Classification
 Histopathology
 Grade
 Stage

45. Stage 1A

46. Stage 1B

47. Stage 2A

48. Stage 2B

49. Stage 3A

50. Stage 3B

51. Stage 4

52. Treatment Medication
Hormone therapy

53. Chemotherapy
 CMF
 CAF (or FAC)
 TAC
 AC → T
 FEC → T
 TC
 TCH

54. Monoclonal antibodies
 Naked monoclonal antibodies
 Conjugated monoclonal antibodies

55. Radiation

56. surgery

57. Screening
 Average-risk women
 Above-average risk women

58.  Self examination

59.  Clinical Breast Examination
 Mammography
 MRI