Breast Disorders

BREAST DISORDERS
MS.MUSKAN TIWARI
M.SC.LECTURER
INTRODUCTION
 Breast disorders may be noncancerous (benign) or

cancerous (malignant). Most are noncancerous and Breast
Disorders breast or of life. Thus, for many women, breast
cancer is their worst fear. However, potential problems an
be detected early when women regularly examine their
breasts themselves, are examined regularly by their doctor,
and have mammograms as recommended Early detection
of breast cancer is essential 10 successful treatment. In this
chapter, we will discuss the tumors of the breast.
 A Tumor is a mass of abnormal tissue There are 2 types of
breast tumors, those that are non life threatening. Often,
they do not require treatment. In contrast, breast cancer
can mean loss of a cancerous, or 'benign, and those that are
cancerous, which are malignant.
BENIGN TUMORS
Benign tumor can be serious if

they are pressing a primary nerve, a
main artery, or compresses any
adjacent organs.
Benign breast conditions are very
common and are encountered by
most of the women. They are not
life-threatening.
FIBROADENOMA
 A fibroadenoma is a very common benign breast condition.

The most common symptom is a lump in the breast which
usually moves when one touches it. Fibroadenomas often
develop during puberty so are mostly found in young
women, but they can occur in women of any age Men can
also get fibroadenomas bur this is very rare.
 Fibroadenoma Mammary glands Fibroadenoma lump in
the breast which has a rubbery texture is smooth to the
touch and moves easily under the skin. Fibroadenomas are
usually painless. bur sometimes they may feel tendes or
even painful. particularly just before a period.
FIBROADENOSIS
Fibroadenosis also known by other names such as

fibrocystic disease of breast or mammary dysplasia
or chronic cystic mastitis.
A biopsy of these lumps usually reveals fibrosis,
adenosis epitheliosis and cyst formation.
It usually presents in the reproductive age of a
women-25 to 35 or 40 years.
The usual common presentation is as a breast
lump of pain in the breast (mastalgia).
The pain or lump may occur just before the
menstrual periods and then disappear.
INTRADUCTAL PAPILLOMA
 Intraductal papillomas are benign, wart-like tumors that grow within

the milk ducts of the breast .
 They are made up of gland tissue along with fibrous tissue and blood
vessels (called fibrovascular tissue) .
 Solitary papillomas (solitary intraductal papillomas) are single tumors
that often grow in the largemilk ducts near the nipple.
 They are a common cause of clear or bloody nipple discharge, especially
when it comes from only one breast.
 They may be felt as a small lump behind or next to the nipple
Sometimes they cause pain.
 Papillomas may also be found in small ducts in areas of the breast
farther from the nipple.
 In this case, there are often several growths and less likely to cause
nipple discharge.
MALIGNANT BREAST CARCINOMA
 It develops from breast tissue Breast

cancer usually starts off in the inner
lining of milk ducts or the lobules that
supply them with milk.
A breast cancer that originates in the
lobules is known as lobular carcinoma,
while one that develops from the ducts
is called ductal carcinoma.
Incidence (MBC)
Breast cancer is the most common

invasive cancer in females
worldwide. It accounts for 16% ofall
female cancers and 22.9% invasive
cancers in women. Approximately
18.2% all cancer deaths worldwide,
including both males and females
are from breast cancer.
Risk Factor
 Early menarche
Late menopause
Nulliparity
Obesity
Late age of first birth (>35 years)
Never breastfed
Atypical lobular hyperplasia
Nipple discharge other than milk
High dose breast or chest irradiation
High dietary fat intake
Alcohol consumption
Estrogen replacement therapy (ERT)
Family history of cancer
Carcinoma in the other breast
Previous cancer of Endometrium, ovary,
colon
Inherited mutations of BRCA1 and BRCA 2
Genes
Sign And Symptoms of Breast Cancer
Lump in the breast

Change in breast shape
Dimpling of the skin
Fluid/blood coming from the nipple
Red scaly patch of the skin
A pain in the armpits or breast that does not
seem to be related to women's menstruation
on period
Pitting or redness of the skin of breast
In those with distant spread of
the disease, there may be:
Bone pain
Swollen lymph nodes
Shortness of breath
Yellow skin
STAGES OF BREAST CANCER
Stages of Breast Cancer Clinical

staging is based on tumor, node
metastasis (TNM) system of the
International Union Again Cancer
This classification considers tumor
size, clinical assessment of axillary
nodes and presence or absence of
distant metasis.
DIAGNOSTIC EVALUATION
Mammography :
 It is the most reliable
means of detecting breast
cancer before a mass can
be palpated in the breast.
Biopsy Technique
Cytology
Fine needle biopsy and
aspiration
Open biopsy
image-guided localization
biopsy
Laboratory finding:
 A complete blood cell count, liver

function test and B-human chorionic
gonadotropin (hCG) in premenopausal
patients to diagnosis pregnancy should
be obtained as part of initial evaluation.
Radiographic Findings
 Plain X-ray:
 Posteroanterior and lateral chest X-ray may show pulmonary
disease involvement and provides radiographic evaluation of
the cardiac outline.
 Computed tomography (CaT) scan of brain and liver is only
required for locally advanced disease.
 Magnetic resonance imaging (MRI) is usually not used. In
T0N1, patient may be helpful in better characterizing the soft
tissues of the tumor .
 Radionuclear scanning: There is no role for this imaging in
screening or in routine work-up of the patient. In evaluation of
metastatic breast cancer, bone scans using Technetium 99 m.
labeled phosphonates are important tools.
TREATMENT OF BREAST CANCER
Surgical Treatment:
Radical mastectomy: In this entire breast, the
underlying pectoralis muscles and contiguous axillary
lymph nodes in continuity are removed.
Extended radical mastectomy: In this internal
mammary lymph node are also removed, but this did
not enhances overall survival rate.
Modified radical mastectomy: In this pectoralis major
muscle is preserved. The breast is removed like radical
mastectomy but axillary lymph node dissection and
skin excision is not extensive.
Total mastectomy:
In this entire breast. nipple and areolar

complex is removed without resection of the
underlying muscle or intentional excision of
axillary lymph nodes. Low lying lymph node
in upper outer portion of breast and low
axilla are often excised. With this method,
there is a higher risk of axillary recurrence.
Breast Conservation Therapy (BCT) with or
without Radiation Therapy
It involves a surgical procedure as lumpectomy:
an excision of tumor mass with a negative surgical
margin an axillary evaluation and postoperative
irradiation. Segmental mastectomy, partial
mastectomy and quadranectomy are also used in
conjunction with radiation and are part of surgical
component of BCT BCT has gained increasing
acceptance as a treatment option of stages I and II
breast cancer Breast.
Radiotherapy
It is used when Locally advanced
cancer with distant metastasis in order
to control ulceration. pain in breast and
regional nodes. In treatment of certain
bones or soft tissue metastasis to
control pain or avoid pathologic
fracture.
Hormonal Therapy
Tamoxifen is recommended as treatment of choice for
hormonal therapy in premenopausal women with
advanced breast cancer In postmenopausal women,
aromatase inhibitors and tamoxifen are the initial
therapy of choice for metastatic breast cancer amenable
to endocrine manipulation. Other agents are
gonadotropin releasing hormones agonists as alternative
to oophorectomy. Progestin, megestrol acetate and
medroxy progesterone acetate are alternative agents
reserved mainly for cases resistant to tamoxifen.
Chemotherapy
Cytotoxic drugs are indicated:
 If visceral metastasis present
If hormonal treatment is
unsuccessful
If tumor is estrogen and
progesterone receptor negative.
Bisphosphonate Therapy
It is recommended if bone metastasis
is confirmed by plain X-ray, MRI/CT
scans It along with other palliative
systemic treatment has been shown to
reduce bony as well visceral metastasis.
It is given intravenously every 3-4
weeks for 2 years or for the duration of
other systemic treatment.

Breast Disorders

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BREAST DISORDERS

 Breast disorders may be noncancerous (benign) or

Benign tumor can be serious if

 A fibroadenoma is a very common benign breast condition.

Fibroadenosis also known by other names such as

 Intraductal papillomas are benign, wart-like tumors that grow within

 It develops from breast tissue Breast

Breast cancer is the most common

Lump in the breast

Stages of Breast Cancer Clinical

 A complete blood cell count, liver

In this entire breast. nipple and areolar

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