3. • Mammary gland.
• Present in both
sexes.
• Rudimentary in
male.
• Well developed in
female after
puberty
4. - In the superficial fascia of the
pectoral region.
Vertically: 2nd to 6th ribs.
Horizontally: lateral border of sternum
to mid-axillary line.
• Above: Clavicle
• Below: 7th to 8th ribs
• Medially: Midline
• Posteriorly : to the edge of latissimus dorsi
11. o Veins follow the arteries.
o First converge around the nipple to form an
anastomotic venous circle & then form 02 sets of
veins.
• Superficial veins: drain into Internal thoracic
vein & superficial veins of the lower part of
the neck
• Deep veins: drain into Internal thoracic ,
Axillary & Posterior intercostal veins
12. AAxxilillalarryy v veeinin
IInntteerrnnaal lt thhoorraaccicic v veeinin
Anastomotic
venous circle
Anastomotic
venous circle
16. Devoid of valves.
•Superficial lymphatics skin over breast except nipple & areola
•Deep lymphatics parenchyma as well as nipple & areola
•SSuubbaarreeoollaarr pplleexxuuss
((ooff SSaappppyy))
Subareolar plexus of
Sappy
18. - Important accessory organ of the female
reproductive system.
- Provides nutrition to the new born in the form of
milk.
19. What is Breast
cancer ?
• The term “breast cancer” refers to a
malignant tumor that has developed from
cells in the breast.
20. • Usually breast cancer either begins in the cells of the
lobules, which are the milk-producing glands, or the
ducts, the passages that drain milk from the lobules to
the nipple. Less commonly, breast cancer can begin in the
stromal tissues, which include the fatty and fibrous
connective tissues of the breast.
• Over time, cancer cells can invade nearby healthy breast
tissue and make their way into the underarm lymph nodes,
(lymph nodes are : small organs that filter out foreign
substances in the body).
• If cancer cells get into the lymph nodes, they then have a
pathway into other parts of the body.
21. Breast Cancer Facts
2nd leading cause of death
2nd most common cancer
Incidence increases with age
All women are at risk
22. Risk factors of breast cancer
(what increases the risk of having breast
cancer ? )
• A “risk factor” is anything that increases
your risk of developing breast cancer. Many
of the most important risk factors for
breast cancer are beyond your control, such
as age, family history, and medical history.
However, there are some risk factors you
can control, such as weight, physical
activity, and alcohol consumption.
23. Risk factors you can control
• Weight
Being overweight is associated with increased risk of breast cancer,
especially for women after menopause. Fat tissue is the body’s main
source of estrogen after menopause, when the ovaries stop
producing the hormone. Having more fat tissue means having higher
estrogen levels, which can increase breast cancer risk.
• Diet.
studies show that eating a lot of red and/or processed meats is
associated with a higher risk of breast cancer. A low-fat diet rich in
fruits and vegetables is generally recommended.
24. • Exercise
Evidence is growing that exercise can reduce breast cancer risk. The
American Cancer Society recommends engaging in 45-60 minutes of
physical exercise 5 or more days a week.
Alcohol consumption
Alcohol can limit your liver’s ability to control blood levels of the
hormone estrogen, which in turn can increase risk
25. Risk factors you can’t
control
• Gender. Being a woman is the most significant risk factor for
developing breast cancer. Although men can get breast cancer, too,
women’s breast cells are constantly changing and growing, mainly due
to the activity of the female hormones estrogen and progesterone.
This activity puts them at much greater risk for breast cancer.
• Age. Simply growing older is the second biggest risk factor for
breast cancer. From age 30 to 39, the risk is 1 in 233, or .43%. That
jumps to 1 in 27, or almost 4%, by the time you are in your 60s.
26. • Race. White women are slightly more likely to develop breast cancer
than are African American women. Asian, Hispanic, and Native
American women have a lower risk of developing and dying from
breast cancer.
• Pregnancy and breastfeeding. Pregnancy and breastfeeding
reduce the overall number of menstrual cycles in a woman’s lifetime,
and this appears to reduce future breast cancer risk
• Family history of breast cancer . If you have a first-degree
relative (mother, daughter, sister) who has had breast cancer, or you
have multiple relatives affected by breast or ovarian
• Radiation therapy to the chest. Having radiation therapy to
the chest area as a child or young adult as treatment for another
cancer significantly increases breast cancer risk. The increase in risk
seems to be highest if the radiation was given while the breasts were
still developing (during the teen years).
27. What causes Breast cancer
• Breast cancer is always caused by a genetic
abnormality (a “mistake” in the genetic material).
However, only 5-10% of cancers are due to an
abnormality inherited from your mother or father.
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.
28. How is the Breast Designed
The breasts sit on the chest
muscles that cover the ribs.
Each breast is made of 15 to 20
lobes.
Lobes contain many smaller
lobules.
Lobules contain groups of tiny
glands that can produce milk.
Milk flows from the lobules
through thin tubes called ducts to
the nipple.
The nipple is in the center of a
dark area of skin called the
areola.
Fat fills the spaces between the
lobules and ducts.
33. • Stage 0:
Cancer cells
remain inside
the breast
duct,
without
invasion into
normal
adjacent
breast tissue.
34. • Stage IA :
The tumor measures up to 2 cm AND the cancer has not spread
outside the breast; no lymph nodes are involved.
Stage IB :
There is no tumor in the breast; instead, small groups of cancer
cells -- larger than 0.2 millimeter but not larger than 2 millimeters –
are found in the lymph nodes OR there is a tumor in the breast that
is no larger than 2 centimeters, and there are small groups of cancer
cells – larger than 0.2 millimeter but not larger than 2 millimeters – in
the lymph nodes.
35. • Stage IIA:
No tumor can be found
in the breast, but
cancer cells are found
in the axillary lymph
nodes (the lymph nodes
under the arm)
OR the tumor measures
2 centimeters or smaller
and has spread to the
axillary lymph nodes OR
the tumor is larger than
2 but no larger than 5
centimeters and has
not spread to the
axillary lymph nodes.
36. • Stage IIB:
The tumor is larger
than 2 but no larger
than 5 centimeters
and has spread to
the axillary lymph
nodes
OR the tumor is
larger than 5
centimeters but has
not spread to the
axillary lymph nodes
37. • Stage IIIA:
No tumor is found in the breast. Cancer is found in axillary lymph
nodes that are sticking together or to other structures, or cancer
may be found in lymph nodes near the breastbone
OR
the tumor is any size. Cancer has spread to the axillary lymph
nodes, which are sticking together or to other structures, or
cancer may be found in lymph nodes near the breastbone.
38. • Stage IIIB:
The tumor may be any size
and has spread to the chest
wall and/or skin of the
breast
AND
may have spread to axillary
lymph nodes that are
clumped together or sticking
to other structures, or
cancer may have spread to
lymph nodes near the
breastbone.
39. • Stage IIIC:
There may either be no sign of cancer in the breast or a tumor may
be any size and may have spread to the chest wall and/or the skin of
the breast
AND the cancer has spread to lymph nodes either above or below
the collarbone AND the cancer may have spread to axillary lymph
nodes or to lymph nodes near the breastbone.
40. • Stage IV:
The cancer has spread — or metastasized — to other parts of the
body.
41.
42. Screening For Breast Cancer
A Good Breast Health Plan
• Self Awareness (Monthly Self
Exams) (BSE)
• Clinical Breast Examination
(CBE)
• Mammograms
43. Screening
Average-size lump found by woman
practicing occasional breast self-exam
(BSE)
Average-size lump found by woman
practicing regular breast self-exam
(BSE)
Average-size lump found by first
mammogram
Average-size lump found by getting regular
mammograms
riz
44. Breast Self Examination (BSE)
• Opportunity for woman to
become familiar with her
breasts
• Monthly exam of the
breasts and underarm area
• May discover any changes
early
• Begin at age 20, continue
monthly
45. When to do BSE
• Menstruating women- 5 to 7
days after the beginning of
their period
• Menopausal women -
same date each month
• Pregnant women –
same date each month
• Takes about 10 minutes
• Perform BSE at least
once a month
• Examine all breast tissue
46.
47. Why don’t more women practice BSE
• Fear
• Embarrassment
• Youth
• Lack of knowledge
• Too busy,
forgetfulness
48. Clinical Breast Examination
• Performed by doctor or
trained nurse practitioner
• Annually for women over
40yrs
• At least every 3 years for
women between 20 and
40 yrs
• More frequent
examination for high risk
patients
49. Mammography
X-ray of the breast
Has been shown to
save lives in patients
50-69
Data mixed on
usefulness for patients
40-49
Normal mammogram
does not rule out
possibility of cancer
completely
56. Prognosis after Breast Cancer
5-Year
Survival (%)
10-Year Survival
(%)
Stage 0 95 90
Stage I 85 70
Stage II 70 50
Stage III 55 30
Stage IV 5 2
57. Facts About Breast Cancer
• Fact # 1 All women are at risk. Approximately 70% of breast
cancers occur in women with none of the known risk factors.
Fact # 2 Only about 5% of breast cancers are inherited. About
80% of women diagnosed with breast cancer will be the first
to be victims in their families.
Fact # 3 Early detection does NOT prevent breast
cancer. Avoiding and elimating known causes will prevent breast
cancer!
58. • Fact # 4 Mammography fails to detect as much as 20% of all
breast cancer and as much as 40% in women under the age of
50.
Fact # 5 One out of four who are diagnosed with breast
cancer die within the first five years.
No less than 40% die within ten years.
Fact # 6 Risk factors are not necessarily causes of breast
cancer. Enough evidence exist linking environmental pollution
and contamination to cause breast cancer.
Fact # 7 The global incidence of breast cancer has
tremendously risen by 256% the past 30 years with
Southeast Asia increasing by 479%! And the supposed
authorities and experts that should know, don't know why.
59. • Fact # 8 Breast cancer is the leading killer of women ages
35 to 54 worldwide. More than a million women develop breast
cancer without knowing it and almost 500,000 die from it every
year.
Fact # 9 1 out of 13 Filipno women will develop breast
cancer in her lifetime.
The province of Pampanga has the highest incidence
rate in the entire country.
Fact # 10 The Philippines has the highest incidence rate of
breast cancer in Asia and registered the highest increase of
589% among 187 countries over a 30 year period from 1980 to
2010.
60. Myths & Facts
•Touching the breasts too often will lead to cancer
•Talking about cancer causes cancer
•Using illegal drugs causes cancer
•Herbs cure breast cancer
(uña de gato/cat’s claw)
•A bruise on the breast will lead to breast cancer.
•If an incision is made during breast cancer surgery,
the cancer will spread.
•Getting too many mammograms leads to
breast cancer.
•Mammograms are only used to evaluate
breast lumps.
61. Myths & Facts
• Breast cancer only affects older women
• If you have a risk factor for breast
cancer, you're likely to get the disease
• Using antiperspirants causes breast
cancer.
• A breast cancer diagnosis is an
automatic death sentence.
• Breast cancer is preventable
65. “Cancer can take my breast and
rob me of a summer but it can't
take my spirit. I've learned that
no matter how bad life gets, I am
the only one who can control my
attitude and I will not let cancer
take that away from me.”
• Katie Adams . A T,A in university of Ottawa
• What was your diagnosis? Stage 2 Breast Cancer
• How did you find out you were sick? What led to your
diagnosis?
• I found a lump and told my doctor about it. From there, there was a
lot of imaging done but because of my age, it was assumed that I did
not have cancer. Two months before my diagnosis, I was told, “You
don't have cancer” by a surgeon. Finally, seven months after telling
my doctor about my lump, a biopsy was done and it came back
positive.
66. • What was the toughest part of your challenge?
Chemo was pretty tough but I think the transition between treatment and finding your
“new normal” has been the hardest for me. I think a lot of time people assume that
when you're done treatment, you're done cancer and if you've ever had cancer, you
know that is not the case. I'm trying to get back to the life I knew but trying to
incorporate cancer into that life.
• What really motivated you to keep going while you were sick?
I knew that other women needed to be helped so I knew if I was strong, it would give
other women strength. I also had such a fantastic support system that picked me up
when I was down and it made it easier to be strong when so many people believed in
me.
• What are your thoughts and feelings about your illness now? How have they
changed since before your diagnosis?
I realize now that having cancer isn't a death sentence and as I mentioned before, you
become an expert about (in my case) breast cancer. I knew virtually nothing
compared to what I know now. Now, when I hear “breast cancer” I have a physical
reaction to it. Rather than just hearing the words, I feel the pain.
67. • What year was it? What was your age at the time? 2011/26
• What were your first thoughts when diagnosed?
• Disbelief, I thought they had the wrong file. I was obviously numb
for a few days, too.
• What did your treatment consist of?
• I had two surgeries (a mastectomy and nine months later, I had the
second part of my reconstruction) and six rounds of chemo. Now I
am on a hormone inhibitor for the next five years that will slow the
growth of cancer if there were any cells that survived surgery and
chemo.
68. ‘I was losing my hair because of the chemo and that affected me greatly. One
day I decided that I was going to take control and I totally shaved my head.
It’s a difficult thing to explain, but it felt like I was taking control for
once.
Andrew Hartling
• How did you find out you were sick? What led to the
diagnosis?
• I noticed a small bump under my right nipple. Being a typical man, I
ignored it for a while but ended up seeing my family doctor in
December 2010. I was told it was probably nothing but I should have
some tests done to make sure. I was sent for an ultrasound and a
mammogram. Being a man and being sent for a mammogram is quite
an experience. The results came back and I was told they still
weren’t quite sure so I was scheduled for a biopsy. It was about a
week later the doctor called me and told me my diagnosis was
Invasive Ductal Carcinoma. I was very confused about what I was
being told and I had to ask him to confirm if that meant I had
cancer. He was very sympatric as he explained to me I had breast
cancer. I was at a loss for words and simply thanked the doctor and
69. • What were your first thoughts when diagnosed?
• I was very scared and confused. My first instinct was that I needed
information and I researched the Internet. There really wasn’t a lot of
information on men’s breast cancer, but I did find an
inspirational story of a gentleman from England who fought breast cancer
and completely recovered. I have read his story at least 100 times.
• What is your current medical status?
• I am currently cancer-free but undergoing chemo and radiation treatments as
a precaution to prevent reoccurrence.
• What is the toughest part of your challenge?
• The toughest part is putting my life on hold for so long. There are so many
things that have changed in the last months and it is overwhelming
sometimes.
• What are your thoughts and feelings about your illness now? How
have they changed since before your diagnosis?
• It’s hard to explain but I was so secretive and private about my diagnosis for
the first months. I didn’t tell anyone I had cancer, much less breast cancer.
People around me knew I something was going on but only my closest circle of
friends knew the truth. It’s been five months now since my first diagnosis and
my attitude has changed. I want to talk about what is happening to me and
ask for help when I need it.It took me quite a while to figure out that I
70. Common misconception
• Common Misconception
• Eating fatty foods causes breast cancer.
• Reality Check!
• Research studies have not been able to prove that there is clearly a direct correlation
between the fat content in food and the dangerous factors that lead to all forms of
Breast Cancer, however it has been proven to be a risk factor increasing the chances of
Breast Cancer in post-menopausal women.
• Common Misconception
• Breast cancer is a fatal disease that kills all patients.
• Reality Check!
• There has been a noticeable increase in the number of women diagnosed with Breast
Cancer each year, but the mortality rate is significantly decreasing. Some reasons for
this phenomenon comprise the enhanced availability and nature of resources for
treatment and early detection of tumors through both Breast Self-examination and
various technologies including X-Ray Mammography.
lobules – glands that produce milk
ducts – tubes that carry milk from the lobules to the nipple
fatty and connective tissue – surrounds and protects the ducts and lobules and gives shape to the breast
areola – the pink or brown, circular area around the nipple that contains small sweat glands, which release (secrete) moisture as a lubricant during breast-feeding
nipple – the area at the centre of the areola where the milk comes out
