Download Breast Cancer

Rick Cirolli MD
Breast Cancer
Specialist in General and Emergency Surgery.
After many years of surgical and medical
experience in Europe and New Zealand he
offers a comprehensive range of surgery.
N Z
Laser Varicose Veins •
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Melanoma
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Circumcision
Breast Surgery
•
Kidney Cancer
0800 247 655
Early detection and diagnosis with prompt
treatment improves prognosis and the
survival rate.
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www.nzgeneralsurgery.co.nz
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For an appointment email
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S u r g e r y
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14 Rutene Rd • Gisborne
Harris
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G e n e r a l
E n d o s c o p y
06 868 9595
www.nzgeneralsurgery.co.nz
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or phone 06 868 9595
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[email protected]
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14 Rutene Rd, Gisborne
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Just remember that nine out of ten women referred
to a breast clinic do not have cancer. And the two
thirds of women who are diagnosed are alive and
well five years later and beyond.
Specialist Services offered
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Be Proactive!
Are You Breast Aware?
Ormond Rd
Invasive breast cancer affected about 1.4 million
new cases worldwide in 2008.
In our district about 60 women are diagnosed each year.
Over the past 25 years, the breast cancer incidence
rates have risen globally, with the highest rates
occurring in the western world. This is most probably
due to early referral to specialist surgeon, better
understanding of this disease and better screening.
Along with the increased detection, the survival and
curative rates have made extraordinary progress.
In New Zealand Breast cancer affects more then
than 2500 women and circa 20 men per year.
About 1 in 10 women are diagnosed with breast
cancer during their lifetime.
70% of new cancers are diagnosed in women over
50 years of age.
At all ages but especially women over the age of 35
years, needs to have appropriate breast awareness
to allow early detection and improved survival rates.
E n d o s c o p y
St
el
Incidence
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Vog
Breast cancer is a malignant tumor of the breast.
It is the most frequently diagnosed life-threatening
cancer in women worldwide.
Increasing public awareness, specialist surgical
assessment and screening have led to earlier
diagnosis, prompt treatment, resulting in improved
survival rates particularly in younger women.
S u r g e r y
Self Referral Welcome
Breast Cancer
Breast Cancer
G e n e r a l
Wain
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Risk Factors
• Early menarche (menstrual period), late
menopause and late or no pregnancies increase
exposure of the breast glands to estrogen in
premenopausal women.
• A strong family history of breast cancer with a
first-degree relative increases the risk of Breast
cancer and in women with 2 or more first-degree
relatives the risk increases 5 times.
• A family history of ovarian cancer.
The literature suggests that the use of oral
contraceptives and hormone replacement therapy
(HRT) increases the risk of 1.25 % in postmenopausal women with the risk being directly
associated with length of exposure to these drugs.
• Obesity, high fatty diet, sedentary life, smoking
and alcohol consumption.
How is it discovered
Breast cancer in younger women is often detected
by chance as an abnormal palpable lump or in a
mammogram before it is felt by the patient or doctor.
Early detection remains the most efficient way to
prevent the development of breast cancer.
For women younger than 40 years, monthly breast
self-examination and clinical breast examination
every 3 years or earlier is recommended and should
begin at age 20 years. Often Breast self-examination
(BSE) is the way a breast lump is discovered, then
the patient should be without delay referred to a
specialist surgeon who will perform a detailed clinical
breast examination (CBE), arrange the appropriate
investigations and deliver adequate awareness and
training to the patient to self-examine the breasts
and armpits. Monthly Breast self-examination and
yearly clinical breast examination are cheap and
noninvasive ways of examining the breasts.
In New Zealand from the age of 45 to 69 women are
under the BreastScreen Aotearoa where they are
screened by mammogram every 2 years.
Once a breast lump is discovered the patient should
be referred to a consultant surgeon who will perform
a complete diagnostic assessment consistent of a
thorough clinical history and examination, organize
an ultrasound scan, mammogram and a biopsy
to obtain the correct diagnosis. In some cases a
breast MRI scan is requested also. It is important
to screen the breast with both Ultrasound scan and
Mammogram as mammography alone could miss
about 10% of breast cancers.
FRONT VIEW OF HEALTHY BREAST
Adipose Tissue (Fat)
Muscle
Lobules
Treatment
When early cancer is detected the patient is often
treated with surgery. Early cancer detection has the
best prognosis and outcome. The type of surgery
depends on the size and the location of the cancer.
Whenever possible breast conservative surgery
(Lumpectomy) is often performed to preserve as
much breast as possible. Some patients require
more extensive surgery such as Mastectomy. Along
with the removal of the cancer some or most of
the lymph gland in the axilla are removed. When
possible a limited excision of lymph glands from the
armpit is performed by a technique called sentinel
lymphnode biopsy.
Some patients after mastectomy qualify for
immediate breast reconstruction, other patients can
have a planned delay reconstruction.
Following surgery often chemotherapy and
radiotherapy are offered to patients to improve the
prognosis and curative rates.
In some patients with advanced breast cancer where
surgery is of no benefit the patient is treated with
both Radiotherapy and Chemotherapy.
Once the cancer is diagnosed and treated, the
patient remains under rigorous surveillance with the
specialist surgeon for a number of years.
What to look for
Any
Any
Any
Any
Any
Any
change in the shape or size of either breast
change in the shape or position of either nipple
flaking, bleeding or discharge from the nipples
unusual dimpling or puckering of the skin
unusual lumps or thickening of the tissue
feelings of pain or discomfort
Lymph Nodes
Areola
Ducts
WHAT TO LOOK FOR
Lump in breast
or armpit
Skin colour changes
or breast, areola or
nipple changes
Inverted nipple
Discharge or bleeding
Breast shape changes