ROJoson PEP Talk: Breast Cancer Development - Fundamentals and Generalities

1. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the DEVELOPMENT
of BREAST CANCER
as a health disorder
or medical disease.
Cancer Course
–
Fundamentals
and
Generalities in
BREAST
CANCER
Development
Nov. 13, 2021
1400H - 1500H
Via Zoom

2. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the DEVELOPMENT
of BREAST CANCER
as a health disorder
or medical disease.
Cancer Course
–
Fundamentals
and
Generalities in
BREAST
CANCER
Development

3. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the DEVELOPMENT
of BREAST CANCER
as a health disorder
or medical disease.
Cancer Course
–
Fundamentals
and
Generalities in
BREAST
CANCER
Development
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

4. There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

5. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer.

6. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the DEVELOPMENT
of BREAST CANCER
as a health disorder
or medical disease.
Cancer Course
–
Fundamentals
and
Generalities in
BREAST
CANCER
Development
My PEP TALK today
is entitled:
Fundamentals and
Generalities in
Development of
Breast Cancer, which
is part of the Cancer
Course.

7. Definition of Terms in Title AND Delimitation of
Coverage of Talk:
Fundamentals – simplest and essential facts and
theories which can serve as a basis or foundation
and support for advanced information
Generalities – general statements of info, not
covering specifics and details
Development of breast cancer – appearance;
growth of breast cancer
Fundamentals
and
Generalities
in BREAST
CANCER
Development

8. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Contents:
• What is a breast cancer?
• How common is breast cancer?
• What are the different types of breast cancer?
• What are the possible and theorized causes of
breast cancer?
• Can breast cancer be prevented?
• Who are at higher risk for developing breast
cancer?
• What are the behaviors of breast cancers?
• How does breast cancer kill a patient?
• Is breast cancer curable?

9. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What is a breast cancer?

10. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What is a breast cancer?
Breast cancer is a medical disease when
some of the breast cells grow
uncontrollably with a potential to invade
the adjacent body tissues or organs and to
spread to distant tissues or organs.
A breast cancer presents as a solid tumor not
liquid tumor.
It is also known as breast malignancy or
malignant tumor of the breast.
(To differentiate it from benign tumor of the
breast which does not invade and spread.)

11. Fundamentals
and
Generalities
in BREAST
CANCER
Development
How common is breast cancer?

12. Fundamentals
and
Generalities
in BREAST
CANCER
Development
How common is breast cancer?
Breast cancer is the most common cancer
in the world and in the Philippines (both
sexes) – GLOBOCAN, 2020
It is more common in females than in
males (100:1).
It is more common in older than younger
females (usually about 40 years old and
older).

13. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the different types of breast
cancer?

14. Fundamentals
and
Generalities
in BREAST
CANCER
Development
NOT all breast cancers are the same.
It is important to know the specific type as
this affects decisions on treatment and
prognosis.
What are the different types of breast
cancer?

15. Fundamentals
and
Generalities
in BREAST
CANCER
Development
There are so many different ways of
describing the types of cancer.
There may be more than 20 types
depending on how the description is done.
What are the different types of breast
cancer?

16. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Primarily based on origin in specific parts
of the breasts –lobules, ducts and
connective tissues in between.
• Lobules – where milk is produced
• Ducts carry breast milk from the
lobules to the nipple
• Connective tissues – blood vessels, fat,
muscles in the breasts
What are the different types of breast
cancer?

17. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Primarily based on origin in specific parts
of the breasts – lobules, ducts and
connective tissues in between.
• Lobules – where milk is produced
• Ducts carry breast milk from the
lobules to the nipple
• Connective tissues – blood vessels, fat,
muscles in the breasts
What are the different types of breast
cancer?
Sarcoma
Adenocarcinoma
Lobular
Ductal

18. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, on the unique appearance of the
cancer cells
• Tubular
• Mucinous
• Medullary
• Papillary
What are the different types of breast
cancer?
Adenocarcinoma

19. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, on the specific cells of origin
• Angiosarcoma – lining of blood / lymph
vessels
• Malignant phyllodes tumor - stroma
• Liposarcoma - fat
What are the different types of breast
cancer?

20. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, on special types
• Paget’s disease of the nipple – affecting
the skin of the nipple and areola
• Inflammatory breast carcinoma –
obstructive cancer cells in the skin’s
lymph vessels
What are the different types of breast
cancer?

21. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, based on whether there is invasion
already or not
• Non-invasive adenocarcinoma
(carcinoma-in-situ) – still within cell
• Invasive adenocarcinoma – outside cell
What are the different types of breast
cancer?
Adenocarcinoma

22. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, based on whether the cancer cells
can be fuelled by hormones
• Hormone-receptor negative
• Hormone-receptor positive
• Estrogen receptors -/+
• Progesterone receptors -/+
What are the different types of breast
cancer?
Adenocarcinoma

23. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, based on genetic make-up of the
cancer cells
• HER2 gene
• Other tumor markers
What are the different types of breast
cancer?
Adenocarcinoma

24. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Then, based on grouping of information on
the cancer cells using receptor-assay and
HER2 gene
• ERA + / PRA+ / HER2 neg
• ERA + / PRA neg / HER2 neg
• ERA neg / PRA neg / HER2 +
• ERA neg / PRA neg / HER2 neg (triple
negative)
What are the different types of breast
cancer?
Adenocarcinoma

25. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?

26. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
Unfortunately, up to now,
most of the time, (90 to 95%)
nobody knows the exact cause of breast
cancer developing in a patient as most of
the time, the cause is multifactorial.
In only 5 to 10% are breast cancers due to
inherited gene mutation from parents.
90 to 95% are “sporadic.”

27. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
All diseases including breast cancers have
underlying, antecedent and immediate causes.
All diseases have predisposing, precipitating and
perpetuating factors.
However, it is difficult to pinpoint the exact cause,
a single cause at that, as oftentimes the cause is
multifactorial.
At best, we can only theorize the possible causes
and factors.

28. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
All diseases have
underlying,
antecedent and
immediate causes.
All diseases have
predisposing,
precipitating and
perpetuating factors.
For a patient with breast cancer, an example in
the analysis or theorized causation for the
development of cancer could be as follows:
- genetic predisposition could be an underlying
cause;
- long-term unhealthy lifestyle could be the
antecedent cause or precipitating and
perpetuating factor; and
- gene mutation is the immediate cause.

29. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
All diseases have
underlying,
antecedent and
immediate causes.
All diseases have
predisposing,
precipitating and
perpetuating factors.
For a patient with breast cancer, an example in
the analysis or theorized causation for the
development of cancer could be as follows:
- genetic predisposition could be an underlying
cause;
- long-term unhealthy lifestyle could be the
antecedent cause or precipitating and
perpetuating factor; and
- gene mutation is the immediate cause.

30. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
All diseases have
underlying,
antecedent and
immediate causes.
All diseases have
predisposing,
precipitating and
perpetuating factors.
For a patient with breast cancer, an example in
the analysis or theorized causation for the
development of cancer could be as follows:
- genetic predisposition could be an underlying
cause;
- excessive exposure to radiation could be the
antecedent cause or precipitating and
perpetuating factor; and
- gene mutation is the immediate cause.

31. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
All diseases have
underlying,
antecedent and
immediate causes.
All diseases have
predisposing,
precipitating and
perpetuating factors.
For a patient with breast cancer, another example
in the analysis or theorized causation for the
development of cancer could be as follows:
- no genetic predisposition but the
underlying cause may be from chemicals which
now also becomes the antecedent cause or
precipitating and perpetuating factor; and
- gene mutation is the immediate cause.

32. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
At the present stage of knowledge, for the
“sporadic” cases, not the inherited gene
mutations from parents, it seems that the last,
ultimate or proximate cause of cancer is changes
(or mutations) to the DNA within cells – the gene.
Thus, one can say that
breast cancer is a
genetic disease—that
is, it is caused by
changes to genes that
control the way our
cells function,
especially how they
grow and divide.

33. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
The three most common theorized ways
by which a gene mutation can instruct a
healthy cell to form cancer are the
following:

34. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
•Allow rapid growth.
A gene mutation (oncogenes) can tell a cell
to grow and divide more rapidly. This
creates many new cells that all have that
same mutation.

35. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
•Fail to stop uncontrolled cell growth.
Normal cells know when to stop growing so that
you have just the right number of each type of
cell.
Cancer cells lose the controls (tumor suppressor
genes) that tell them when to stop growing.
A mutation in a tumor suppressor gene allows
cancer cells to continue growing and
accumulating.

36. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
•Make mistakes when repairing DNA
errors.
DNA repair genes look for errors in a cell’s
DNA and make corrections.
A mutation in a DNA repair gene may
mean that other errors aren’t corrected,
leading cells to become cancerous.

37. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
All diseases have
underlying,
antecedent and
immediate causes.
All diseases have
predisposing,
precipitating and
perpetuating factors.
What causes gene mutations?
What are the underlying and antecedent
and immediate causes?
What are the predisposing, precipitating
and perpetuating factors?

38. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
Gene mutations can occur for several
reasons, for instance:

39. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
Gene mutations you’re born with.
You may be born with a genetic mutation
that you inherited from your parents.
This type of mutation accounts for a small
percentage of cancers.
[Underlying / Predisposing Cause]

40. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
Gene mutations that occur after
birth.
Most gene mutations occur after you’re born and
aren’t inherited.
A number of forces can cause gene mutations,
such as smoking, radiation, viruses, cancer-
causing chemicals (carcinogens), obesity,
hormones, chronic inflammation and a lack of
exercise. [Antecedent / Precipitating /
Perpetuating Cause]

41. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the possible and theorized
causes of breast cancer?
The gene mutations you’re born with
and those that you acquire
throughout your life work together to
cause cancer.

42. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Can breast cancer be prevented?

43. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Can breast cancer be prevented?
YES, but not all – not 100% preventable.
Breast cancers develop through multiple
factors such as genetic predisposition;
environmental factors including lifestyle;
and aging that it is difficult to identify a
sure-shot specific strategy of prevention.

44. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Can breast cancer be prevented?
YES, but not all – not 100% preventable.
There are some things that can increase
the risk of cancer that we can't change.
These include things like damaged DNA
inherited from a parent; family history;
and getting older.

45. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Can breast cancer be prevented?
AGE as a risk factor
in DNA CHANGE –
gene mutation –
cancer
development
More mutations in
older people!

46. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Can breast cancer be prevented?
YES, but not all – not 100% preventable.
Though managing certain controllable risk
factors – such as diet, physical activity and
other lifestyle choices – can lower your
chances of developing breast cancer,
But NO guarantee – best effort!

47. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Who are at higher risk for developing
breast cancer?

48. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Who are at higher risk for developing
breast cancer?
The exact specific cause of breast cancer
developing in a particular patient is
difficult to pinpoint.
For a preventive program against breast
cancers, know the risk factors; know the
controllable ones and then, control and
mitigate them.

49. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Who are at higher risk for developing
breast cancer?
Risk factors if present affect your chances
of getting a breast cancer, but having a risk
factor does not mean that you are
guaranteed to get it.

50. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Who are at higher risk for developing
breast cancer?
Again, to emphasize –
Though managing certain controllable risk
factors – such as diet, physical activity and
other lifestyle choices – can lower your
chances of developing breast cancer,
But NO guarantee – best effort!

51. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Who are at higher risk for developing
breast cancer?
Uncontrollable risk factors:
• Female
• Aging
• Family history of breast cancers
• History of breast cancer on one breast
• Inherited breast cancer genes from
parents

52. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Who are at higher risk for developing
breast cancer?
Controllable risk factors:
• Being overweight and obese
• Lacking adequate amount of exercise
• Drinking alcohol excessively
• Using hormone replacement therapy
• Smoking tobacco or exposing to
tobacco smoke
• Exposing to excessive radiation
particularly to the chest

53. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Can breast cancer be prevented?
Cancer Prevention - Mitigation Tips on
Controllable Risk Factors:
1. Maintain a healthy weight.
2. Have adequate amount of exercise.
3. Drink alcohol in moderation.
4. Limit use of hormone replacement therapy.
5. Avoid exposure to tobacco smoke.
6. Avoid excessive radiation exposure.
7. Eat healthy diet (more of plant-based diet)
8. Be in touch with reliable medical information
on breast cancer risk and prevention.

54. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the behaviors of breast cancers?
Once a breast cancer develops, it has the
potential to grow and invade or infiltrate adjacent
organs or tissues and also the potential to spread
to distant sites in the body.
The rate of growth and spread of the cancer is
dependent primarily on the behavior of the
mutated genes and secondarily on the presence
of promoting factors in the person’s body like
medications and hormonal levels and in the
environment like cancer-causing chemicals.

55. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the behaviors of breast cancers?
A breast cancer that has spread to
another place in the body is called
metastatic cancer.
The process by which cancer cells spread
to other parts of the body is called
metastasis.

56. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the behaviors of breast cancers?
Metastatic cancer has the same name and
the same type of cancer cells as the
original, or primary, cancer.
For example, breast cancer that forms a
metastatic tumor in the lung is metastatic
breast cancer, not lung cancer.

57. Fundamentals
and
Generalities
in BREAST
CANCER
Development
What are the behaviors of breast cancers?
The most common regional site of spread
is the armpit lymph node.
The more common distant sites of spread
are:
• Bone
• Lungs
• Brain
• Liver

58. Fundamentals
and
Generalities
in BREAST
CANCER
Development
How does a breast cancer kill a patient?

59. Fundamentals
and
Generalities
in BREAST
CANCER
Development
How does a breast cancer kill a patient?
Breast cancer can directly kill a patient
when it
• invades (spreads or metastasizes to)
essential organs, like lungs, bone, liver,
and/or brain and stops them from
functioning properly.
Direct causes of
death in breast
cancer

60. Fundamentals
and
Generalities
in BREAST
CANCER
Development
How does a breast cancer kill a patient?
Indirect or
secondary causes
of death in breast
cancers
Breast cancer can kill a patient secondarily
(indirectly) through:
• Complications during surgery
• Complications from other forms of
treatment such as chemotherapy
• Infection due to compromised immune
system
• Malnutrition

61. Fundamentals
and
Generalities
in BREAST
CANCER
Development
How does a breast cancer kill a patient?
Indirect or
secondary causes
of death in breast
cancers
Two of the leading causes of death for those with
breast cancer are:
•Venous thrombosis
•Pulmonary embolism
Both of these conditions come from blood clots.
They may end up getting stuck in another part of
your body, like your brain or lungs. When the
blood clot gets lodged in one of these areas,
blood flow gets cut off, and the result can be
deadly.

62. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?

63. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
Before I answer this question, let’s have a
definition of MEDICAL CURE.
The conventional definition of “medical cure”: a
medical condition that’s completely gone and will
never come back.
For example, if you have appendicitis and doctors
remove your appendix, you’ve been cured.
If you have gallbladder stones and doctors
remove your gallbladder with the stones, you’ve
been cured of the problem.

64. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
For breast cancers, there are patients who after
treatment do not have their cancers coming back
10, 15 years after or even longer.
Strictly speaking, they can be considered
“CURED.”
However, doctors do not want to categorically use
the word “CURE” for them. They use the word
“IN REMISSION.”

65. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
Doctors can talk of “curative goal” at the time of
treatment when eradicating the cancers entirely
can be done with known effective treatment. At
this time, they will just hope the cancers will not
recur.
The end effect of “curative treatment” can be
“CURE” if no cancer recurs after so many years.
However, doctors will never say and guarantee
CURE to any cancer patient after any type of
treatment.

66. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable? There are theories on how
gene mutations lead to
cancer development:
- Allowing rapid growth
- Failure to stop
uncontrolled growth
- Makes mistakes when
repairing DNA errors
EXACT MECHANISMS –
NOT DEFINITELY KNOWN
YET!
Thus, the targeted cancer
therapies on the molecular
or gene level are not yet
100% successful.
Why no doctors guarantee cure for cancer (that it
will not come back even after treatment)
There are several reasons for this:
1. Doctors don’t know everything about
breast cancer as a disease yet.
The best knowledge so far is that the ultimate or
proximate cause of cancer is changes (or
mutations) to the DNA (genes) within cells; that
cancer is a genetic disease caused by changes
to genes that control the way our cells function,
especially how they grow and divide.

67. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
Why no doctors guarantee cure for cancer (that it
will not come back even after treatment)
There are several reasons for this:
2. The usual cancer treatment modalities
(surgery, chemotherapy, and radiotherapy)
are strictly not treating the primary cause
of the cancer. They just extirpate, kill with
drugs, and burn the cancer. If the primary
cause is still around, there is always the
possibility of recurrence after treatment.

68. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
Why no doctors guarantee cure for cancer (that it
will not come back even after treatment)
There are several reasons for this:
3. No two cancers are the same. Each
individual cancer possesses different biological
characteristics, even cancers of the same type and
same extent. Some are slow growing while some
are fast growing. Usually, the biologic behavior of
the cancer is not known at the time of treatment.
Thus, only time will tell the outcome of
treatment.

69. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
Why no doctors guarantee cure for cancer (that it
will not come back even after treatment)
There are several reasons for this:
4. After treatment, some cancer cells may
remain somewhere in the body (unnoticed
and patients are asymptomatic) for a long
time, even as long as 10 years, but can
eventually grow, divide, invade, spread to
distant areas and become a nuisance. (A
RECURRENCE)
At the time there are
no symptoms of
cancer, doctors use
the word
“REMISSION.” They
do not guarantee
completely no more
cancer.
Some cancer cells may
be present but
unnoticed.

70. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
Complete remission means that tests,
physical exams, and scans show that all
signs of your cancer are gone.
Some doctors also refer to complete
remission as “no evidence of disease
(NED)” or “no evidence of recurrence
(NER)”.
COMPLETE REMISSION DOESN’T MEAN
CURE.

71. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
RECURRENCE
Some cancer cells can remain unnoticed in
the body for years after treatment.
If a cancer returns after it has been in
remission, it’s called a “recurrence.”
A cancer can recur in the same place it was
originally diagnosed, or it can recur in a
different part of the body.

72. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
So, up to now, strictly speaking, there is
NO true “cure” for cancer (NO guarantee it
will not recur).
Physicians do not talk of “cure.” They use
the word “remission” if there are no signs
of recurrence.
But they together with the patients always
hope for a cure especially for those
cancers which are recognized, diagnosed
and treated early and with known track
record of slow growth in behavior.

73. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Is breast cancer curable?
To boost the morale of breast cancer
patients though, one may say that a
patient is cured already if there is no
recurrence after 10 years or more. (Note:
there is always exception to this, though).
LONG REMISSION is usually seen in
patients diagnosed and treated early.

74. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Contents:
• What is a breast cancer?
• How common is breast cancer?
• What are the different types of breast cancer?
• What are the possible and theorized causes of
breast cancer?
• Can breast cancer be prevented?
• Who are at higher risk for developing breast
cancer?
• What are the behaviors of breast cancers?
• How does breast cancer kill a patient?
• Is breast cancer curable?
Summary
Conclusion
Take Away

75. Fundamentals
and
Generalities
in BREAST
CANCER
Development
Take Away in
relation to
Patient
Empowerment
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to prevent breast cancer and in case it is
not prevented, to gain greater control over
decisions in management.
Be always in touch with reliable medical
information on fundamentals and
generalities in breast cancer development.

76. Empowerment
objective - for
laypeople to have an
understanding of
the FUNDAMENTALS
and GENERALITIES in
the DEVELOPMENT
of BREAST CANCER
as a health disorder
or medical disease.
Cancer Course
–
Fundamentals
and
Generalities in
BREAST
CANCER
Development