Download Breast cancer prevention

Breast cancer prevention
By Julian Kunz
What is Breast cancer?

Also known as mammacarcinoma
 A malign tumor spreading from the lobar
epithelium (lobar carcinoma) or the
lactiferous ducts (ductal carcinoma)
Etiology

Most common malign tumor in the female
population (~ 25%)
 In women between 30 and 60 it is the most
common cause of death in the western world
 In germany 17000 women die of it every year
 Even though it is very rare men can be affeceted
too
Cause of death
„mammacarcinoma“
Age
0 – 30
30 – 40
40 – 50
50 – 60
60 – 70
70 – 80
80 >
2003
0.4
10
13
14
9
4
2
2004
0.5
11
14
14
10
5
2
2005
0.5
10
14
13
10
4
2
2006
0.4
11
13
14
10
5
2
Risks and Causes

Genetic factors: play a big rule in the type of
breast cancer affecting young women
 Breast cancer virus: Since the 1930s researchers
have been looking for a virus analogous to the
mamma-tumor-virus causing benign cancer in
mice
 Birth control pills: The adverse effect of these
drugs hasn‘t been completely discovered; however
there is a moderate risk increase if the medication
has been taken for longer than 5 years
Risks and Causes

Hormone therapy: to reduce symptoms
menopause
 Pregnancy: an early first pregnancy reduces
the risk of breast cancer
 Osteoporosis prevention: calcium and
vitamin D therapy also decrease the risk of
breast cancer markedly
Prevention and Screening
80 – 90% of all changes are discovered by
women themselves even though only 20%
examine themselves
 The examination should be done on a
monthly basis 5-7 days after menorrhoea
 In case of a palpated anomaly women
should consult their physician for a more
detailed examination

„Discovering Hands“

Blind people have a highly developed sense
of touch
 This special ability might be put to use in
North Rhine-Westfalia (NRW)
 In case of success it would create a new
profession for blind women
 Training programs will begin in 2008
Mammography



Is an x-ray examination
with a special apparatus
The breast is comprimed
between two plates of
plexiglass to keep the
breast in position (might
result in bruises)
The applied x-rays are
rather soft (26-30 keV) to
increase the contrast 
small neoplasmatic tissue
formations can be seen
Sonography

Ultrasound-based technique done after
palpation of an anomaly to rule out possible
cysts and to estimate the size of the tumor

Only in addition to mammography as
neither microcalcium nor tumors smaller
than 5mm can be detected
MRI

An important imaging technique to find out
if the breast has been affected by more than
one tumor
 Multifocality: more than one tumor in the
same quadrant
 Multicentrality: other tumors in other
quadrants
Computer Assisted Detection
(CAD)

CAD systems help searching digital images
for typical structures and also to point out
possibly diseased regions
 It is a relatively young interdisciplinary
technology combining elements of artificial
intelligence and digital image processing
 It serves mostly as a second opinion to the
report of the responsible physician
Mammography-ScreeningCenters

Currently a network of quality assured
screening centers is being build up in
Germany
 Woman between the age 50 and 70 are
invited once a year to get a mammography
 In case of a report of an anomaly in the scan
they are send for a biopsy of the suspicious
tissue formation
Punching Biopsy

A needle is shot at
high velocity into the
neoplasmatic tissue
 Done in locally
sedated state
 (At least 3 samples
are taken to avoid
mistakes
Needle Biopsy

With a syringe and a special needle tissues
are drawn from a palpable tissue formation
 As painful as venipuncture
 In case of a malign tumor the result is sure
wheras it is only 90% sure for a benign
tumor
Advanced Breast Biopsy
Instrumentation (ABBI)




Biopsy with relatively
large probe (6-20 mm)
Done with x-ray to ensure
localisation of target
Mostly used for analysis
of microcalcification
Has only been in use for a
few years  many
unexperienced physicians