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1. PATHOPHYSIOLOGY OF BREAST CANCER
PREDISPOSING FACTORS ETIOLOGY PRECIPITATING FACTORS
Gender (Unknown) Diet
Age Hx of taking oral
Genetics contraceptives
Noncompliance to
treatment
Immunosuppression
Genetic mutation of the cellular DNA
(P53, BRCA-1, & BRCA-2 genes)
Activation of growth-promoting Inactivation of tumor suppressor Alterations in the gene that
oncogenes genes controls apoptosis
Unregulated proliferation and differentiation of
cancer cells in the milk duct
Growth of a malignant tumor
A

2. A
Activation of immunologic Release of growth factors
mechanism Cancer cells destroy
normal RBCs
Cancer cells release Angiogenesis
Release of B-lymphocytes, exosomes
T-lymphocytes & Natural Anemia of Chronic disease
Killer cells
Impairment of the immune ↓ Lymphocytes
response
↓ RBC Pale nail beds
Death of some Cancer cells ↓Hgb ↓ Capillary refill
Immunosuppression
Pneumonia of Release of Neutrophils and
Crackles Immunosupression Macrophages
Malignant tumor grows
rapidly
Production of Pyrogenic
Productive cough
cytokines: (IL-1)
DOB
C B
Fever

3. B
Change in symmetry or size Rapid multiplication of Malignant tumor obstructs Malignant tumor tends to compress
of the breast cancer cells the milk duct blood and lymphatic vessels
Rupture of milk duct
Rapid metabolism caused by
the cancer cells
↓ Blood supply to the
breast tissue
Inflammatory response
Normal cells are deprived of
C nutrients
Ischemia
Release of chemical
mediators:
Unexplained Bradykinins & Prostaglandins
Necrosis
weight loss
Fatigue Transient vasoconstriction
Limited ROM (3/5) F
D
E
G

4. D E F G
Vasodilation Blood and lymph stasis Cancer cells begin to spread
locally via lymphatic vessels
↑Vascular permeability
Presence of cancer cells in
lymph nodes
Plasma fluid leaks into the
tissue
Palpable, immovable,
Swelling Tissue decay hard & painless nodes:
Supraclavicular and
axillary lymph nodes
(2 cm)
Compression of the nerve
endings Foul odor
Pain
Accumulation of fluid, cells
and cellular debris & live and Pus
dead lymphocytes