Download Breast cancer presentation notes

Breast cancer presentation notes
What is it
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Video till 1:08
Malignant means is can spread or metastasize
Anatomy
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Develops in the lobes, ducts or both.
Tumor is classified as malignant once it becomes invasive (aka spreads)
Distinguishing site of origin
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Both ductal carcinoma and lobular carcinoma can be in situ, which means that the cancer
is still where it started (Non-invasive) and has not grown into surrounding tissues.
4 types of breast cancer invasive and non-invasive ductal carcinoma, and invasive and
non-invasive lobular carcinoma.
Invasive cancers, also referred to as infiltrating. Basically means which means they have
grown into surrounding tissues. While non-invasive does not
Cancer cells can invade nearby healthy breast tissue and make their way into the
underarm lymph nodes.
Within these 4 types of breast cancer there are 4 classifications we will address next. Also
stages of breast cancer which refer to how far the cancer cells have spread past the
original tumor.
Inherited genes, mutations or defects
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Gene Irregularities, mutations or damaged DNA are the beginning of breast cancer as the
immune system normally seeks out cancer cells and cells with damaged DNA and
destroys them.
Breast cancer may be a result of failure of such an effective immune defence and
surveillance.
This lack of a tumor suppressor can be a lifetime risk.
Types of breast cancer
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ER+ =estrogen receptor positive
PR+= progesterone receptor positive
HER2= human epidermal growth factor receptor 2
Types of breast cancer (2)
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Hormone receptor cancers respond well to hormonal therapy
HER2 positive cancers are generally treated with drugs. De-stimulate the growth of
HER2.
 Triple-negative is difficult to deal with as it does not respond to therapies that target
hormone reception or HER2 production. Usually dealt with by chemotherapy.
 In general, surgical and radiation treatments are similar for these different types of breast
cancer. But drug treatments -- such as chemotherapy, endocrine therapies, and other
medications -- are usually different.
 These treatments are targeted to the specific type of cancer., but we’ll discuss treatment
more shortly.
Diagnosis
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All pretty straight forward on each slide.
Staging
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Once the TNM system has been referred to we can distinguish which stage the cancer is
in.
Surgery
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Breast-conserving surgery:
Also known as lumpectomy or wide local excision, involves resection of the tumour
along with a margin of tissue while conserving the cosmetic appearance of the breast.
Most breast surgeries are of this type because
- (i) most tumours are locally invasive and
- (ii) large primary tumours can be reduced in size by chemotherapy prior to
conservative surgery.
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Mastectomy:
surgical removal of entire breast, including the fascia over the pectoralis muscles.
Surgeons may preserve some skin and the nipple/areola for reconstruction.
The indication for mastectomy is:
-Multicentric invasive carcinoma (multiple invasive sites)
-inflammatory carcinoma
-or extensive intraductal carcinomas. (taking over a large percentage of the ducts)
Axillary lymph node dissection:
Removal of the lymph nodes draining the breast tissue for lymph node micrometastasis.
This is done at the same time as BSC or mastectomy.
However, recent evidence suggests that axillary lymph node biopsy is unnecessary
regardless of whether the sentinel lymph node biopsy is negative or positive because
there is no mortality benefit.
Adjuvant therapy:
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cytotoxic chemotherapy, endocrine therapy, or radiation therapy may be used
postsurgery to prevent relapse.
These therapies increase the desired immune response to prevent relapse.
Radiation therapy
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Always given after surgery to destroy any remaining cancer cells
Highly targeted and highly effective way to destroy cancer cells in the breast that may
stick around after surgery.
Radiation can reduce the risk of breast cancer recurrence by about 70%.
Radiation therapy is relatively easy to tolerate and its side effects are limited to the
treated area despite certain myths.
Endocrine therapy
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ER+ and PR+ breast cancers are stimulated by their respective hormone.
Endocrine therapy reduces production of these hormones.
Chemotherapy
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Drugs used depends on the stage of breast cancer and how invasive it is.
Most breast cancer is treated with an anthracycline, a taxane or both types of drugs.
Cytoxic drugs
Harder (2015)
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These treatments often damage lymphatic drainage from the arm and women may
develop shoulder and arm dysfunction. As well as discomfort, there can be restricted
movement, pain, numbness and other sensory problems
Methods
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Patient reported outcomes: Looked at the Functional Assessment of Cancer Treatment; a
recognised quality of life (QoL) tool with an arm morbidity subscale.
Conclusions
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The addition of a self-practise general yoga programme was well received and appeared
to improve QoL at 6 months.