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Breast Cancer
Faraza Javed
M.Phil Pharmacology
Breast Cancer
Breast cancer is second only to lung cancer as a
cause of cancer deaths in women.
 Cancer that has not spre...
Pathophysiology
 Breast cancer, like other cancers, occurs because of an
interaction between an environmental (external) ...
 Breast tissues consist mainly of fatty tissue interspersed
with connective tissue. Each tissue has 15 to 20 sections
tha...
 Lymph ducts: Drain fluid that carries white blood cells
(that fight disease) from the breast tissues into lymph
nodes un...
Three Types of Vessels
Bacteria
Blood
Vessels
Cell life
2
Lymph
Nodes
Lymph
Vessels
3
MilkLobules Ducts Nipple
1
90% of cases are reported with ductal carcinoma. Lobular
carcinoma is very rare. If cancer confines to duct it is
benign o...
 It has also been observed that breast stromal cells can
modulate the growth of normal and neoplastic breast
epithelial c...
Risk Factors
 Obesity
 Age
 Alcohol Consumption
 Hormone Replacement Therapy
 Ionizing Radiation
 Having Children la...
Symptoms
 Lump in the breast tissue
 Dimpling of skin
 Skin irritation
 Red Scaly Patch on Skin
 Swollen Lymph Nodes
...
Diagnostic Parameters
Mammogram:
A mammogram is a special type of X-ray taken to look for
abnormal growths or changes in b...
MRI:
MRI may be used to find out how much the disease has
grown throughout the breast the tissue.
Biopsy:
Removal of cells...
Molecular Testing of Tumor:
The standard tests to further evaluate the cancer include
estrogen receptor (ER), HER-2 tests....
Treatment
The American Joint Committee on Cancer (AJCC) and
the International Union against Cancer (UICC)
recommend TNM st...
The management of breast cancer depends on various
factors, including the stage of the cancer and the age of the
patient. ...
1. Surgery
Mastectomy: Removal of the whole tissue.
Lumpectomy: Removal of a small part of the tissue.
2. Medication
There are currently three main groups of medications used
for adjuvant breast cancer treatment after surgery...
Chemotherapy: Chemotherapy is predominantly used for
cases of breast cancer estrogen receptor-negative (ER-)
disease. The ...
Targeted Therapy:
Monoclonal Antibodies: Trastuzumab, a monoclonal
antibody to HER2 which is only effective in patients wi...
3. Radiotherapy
Radiotherapy is given after surgery to the region of the tumor
bed and regional lymph nodes, to destroy mi...
Cancer’s Seven Warning Signals
Awareness Programs
Ribbon Awareness Campaign
You can be a victim of cancer or a survivor of
cancer.
It’s a mindset.
Hope is the Physician of Each Misery
Thankyou..
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Breast Cancer

  1. 1. Breast Cancer Faraza Javed M.Phil Pharmacology
  2. 2. Breast Cancer Breast cancer is second only to lung cancer as a cause of cancer deaths in women.  Cancer that has not spread is called in situ, meaning “in place.”  Cancer that has spread is called invasive or infiltrating.
  3. 3. Pathophysiology  Breast cancer, like other cancers, occurs because of an interaction between an environmental (external) factor and a genetically susceptible host.  About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.  The etiology of breast cancer is still poorly understood with known cancer risk factors explaining only a small proportion of cases.
  4. 4.  Breast tissues consist mainly of fatty tissue interspersed with connective tissue. Each tissue has 15 to 20 sections that are termed as Lobes. Inside each lobe are many smaller structures called Lobules/Ducts that contain mammary glands.  Oxygen, nutrients, and other life-sustaining nourishment are delivered to breast tissue by the blood in the arteries and capillaries.
  5. 5.  Lymph ducts: Drain fluid that carries white blood cells (that fight disease) from the breast tissues into lymph nodes under the armpit.  Lymph nodes: Filter harmful bacteria and play a key role in fighting off infection.
  6. 6. Three Types of Vessels Bacteria Blood Vessels Cell life 2 Lymph Nodes Lymph Vessels 3 MilkLobules Ducts Nipple 1
  7. 7. 90% of cases are reported with ductal carcinoma. Lobular carcinoma is very rare. If cancer confines to duct it is benign or in situ but if move beyond duct, termed as malignant or invasive. Genetic abnormality due to any mutation allows the cells to divide more rapidly than healthy cells do and may spread through the breast, to the lymph or to other parts of the body (metastasize) e.g. lungs or liver.
  8. 8.  It has also been observed that breast stromal cells can modulate the growth of normal and neoplastic breast epithelial cells and can secrete growth factors following stimulation by endogenous hormones. The adipose tissues contain aromatase enzyme, which produces oestradiol from circulating cholesterol. Because of the higher proportion of these fat cells in breasts of older women, the levels of oestradiol in are much greater than their plasma levels. This probably accounts for the rising incidence of breast cancer with ageing and supports the role of steroid hormones in the pathogenesis of breast cancer. 
  9. 9. Risk Factors  Obesity  Age  Alcohol Consumption  Hormone Replacement Therapy  Ionizing Radiation  Having Children late or not at all  History of Cancer  Genetics (BRCA1, BRCA2, HER-2)
  10. 10. Symptoms  Lump in the breast tissue  Dimpling of skin  Skin irritation  Red Scaly Patch on Skin  Swollen Lymph Nodes  Constant Pain in breast and armpit area
  11. 11. Diagnostic Parameters Mammogram: A mammogram is a special type of X-ray taken to look for abnormal growths or changes in breast tissue. Breast Ultrasound: An ultrasound can distinguish between a solid mass, which may be cancer, and a fluid-filled cyst, which is usually not cancer.
  12. 12. MRI: MRI may be used to find out how much the disease has grown throughout the breast the tissue. Biopsy: Removal of cells from a suspicious mass to see if it’s cancer or not. Positron Emission Tomography: PET may also be used to find out whether the cancer has spread to organs.
  13. 13. Molecular Testing of Tumor: The standard tests to further evaluate the cancer include estrogen receptor (ER), HER-2 tests. The presence of these receptors helps determine the type of treatment that is most likely to lower the risk of recurrence. Generally, hormonal therapy works well for ER-positive cancers, also called hormone receptor-positive cancers. If a person’s tumor does not have ER, the tumor is categorized as negative tumor type. This type of cancer usually grows and spreads more quickly than hormone receptor-positive disease.
  14. 14. Treatment The American Joint Committee on Cancer (AJCC) and the International Union against Cancer (UICC) recommend TNM staging. Their TNM system, which they now develop jointly, classifies cancer by several factors, T for tumor, N for nodes, M for metastasis and helpful to some extent in treatment approaches.  T describes the size of the original (primary) tumor and whether it has invaded nearby tissue,  N describes nearby (regional) lymph nodes that are involved,  M describes distant metastasis (spread of cancer from one part of the body to another).
  15. 15. The management of breast cancer depends on various factors, including the stage of the cancer and the age of the patient. Breast cancer is usually treated with surgery, which may be followed by chemotherapy or radiation therapy, or both. A multidisciplinary approach is preferable. Hormone receptor-positive cancers are often treated with hormone-blocking therapy over courses of several years. Monoclonal antibodies, or other immune- modulating treatments, may be administered in certain cases of metastatic and other advanced stages of breast cancer.
  16. 16. 1. Surgery Mastectomy: Removal of the whole tissue. Lumpectomy: Removal of a small part of the tissue.
  17. 17. 2. Medication There are currently three main groups of medications used for adjuvant breast cancer treatment after surgery. Hormone Blocking Therapy: Some breast cancers require estrogen to continue growing. These ER+ cancers can be treated with drugs that either block the receptors, e.g. Tamoxifen, or alternatively block the production of estrogen with an Aromatase inhibitor, e.g. Anastrozole or Letrozole. The use of tamoxifen is recommended for 10 years.
  18. 18. Chemotherapy: Chemotherapy is predominantly used for cases of breast cancer estrogen receptor-negative (ER-) disease. The chemotherapy medications are administered in combinations, usually for periods of 3–6 months. One of the most common regimens, known as "AC", combines Adriamycin(Doxorubicin)+ Cyclophosphamide. Another common treatment is Cyclophosphamide+ Methotrexate+ Fluorouracil (or "CMF").
  19. 19. Targeted Therapy: Monoclonal Antibodies: Trastuzumab, a monoclonal antibody to HER2 which is only effective in patients with HER2 amplification/overexpression. Bevacizumab (Avastin): Blocks angiogenesis (the formation of new blood vessels) and is under evaluation in clinical trials. Lapatinib: Tyrosine Kinase Inhibitor only used to treat HER2 positive metastatic breast cancer.
  20. 20. 3. Radiotherapy Radiotherapy is given after surgery to the region of the tumor bed and regional lymph nodes, to destroy microscopic tumor cells that may have escaped surgery.
  21. 21. Cancer’s Seven Warning Signals
  22. 22. Awareness Programs Ribbon Awareness Campaign You can be a victim of cancer or a survivor of cancer. It’s a mindset.
  23. 23. Hope is the Physician of Each Misery Thankyou..
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Breast Cancer, Pathophysiology, Diagnosis and its Treatment

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