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AN OVERVIEW ON BREAST CANCER DR BASHIR BN YUNUSOUTLINE • INTRODUCTION • RISK FACTORS • PATHOLOGY • DIAGNOSIS • TREATMENT • PREVENTION • REFERENCESINTRODUCTION • Breast cancer is the most common malignancy in women and comprises 18% -25 % of all female cancers and 1% in males with a M:F 1:103 • In Nigeria, Commonest malignancy in Ibadan. In Ghana , it accounts for 16% of all malignancies. • Life time risk for developing breast CA is about 12%, this higher in Caucasians than in blacks. • Incidence increases with age. Only 5% occur in women < 40yrs of age • Account about 14% mortality, However, patients in developing countries are more likely to die from the disease due to late presentation, lack of adequate screening and diagnostic modalities and limitation in treatment options.RISK FACTORS • Only 30% have well-established risk factors. 70% are idiopathic, with no wellestablished risk factors (apart from gender +- age) • Major • Age • Sex • Genetic predisposition • Previous breast cancer • Intermediate • Hormonal factors • Irradiation • Benign breast disease with severe atypia • Diet • alcohol • Minor • obesity • Benign breast disease with mild to moderate atypiaAGE • Risk increases with advancing age (especially after 50yrs). • Rare before 20yrs (<2% cases) • Incidence rises steadily between 30-80 years, until 80yrs when it becomes flat. • However, young individuals (<45yrs) that develop breast CA tend to have more aggressive disease and are more likely to be African. SEX • 99% of breast CA occurs in women, while men have 1%. RACE • Higher in Caucasians than blacks. In the US (1 in 8) and 1 in 14 among blacks.GENETIC PREDISPOSITION • (Hereditary): 5-10% of breast CA have a strong inherited risk due to some genetic defects inherited from the parents. Such patients usually have a positive family history • Breast CA: • Sporadic- 70-85% • Inherited (15-30%): • Familial- 10-20%; • Genetic- 5-10% • Hereditary breast CA is usually characterized by early age of onset, high incidence of bilateral disease and associated with ovarian, colonic or prostate (in men) cancer.GENES • BRCA • BRCA 1 and 2 mutation (Breast related cancer antigen OR Breast Cancer antigen): • BRCA is a tumour suppressor gene. • BRCA gene co-ordinates the repair of damaged DNA strands of PTEN. Cells with BRCA mutation are not able to repair damaged PTEN. This allows the cells to continue uncoordinated growth and ultimately become malignant. • Patients with BRCA mutation have 60-80% risk of developing breast CA in their lifetime • 80% of hereditary breast CA cases have BRCA mutation. • INHERITED AS AUTOSOMAL DOMINANT• BRCA 1: located on 17q21 • 65-85% risk of breast CA. • Predisposes to breast and prostate CA • Invasive ductal breast CA which is usually triple negative-ER-, PR-, HER2/neu Such tumours are thus high grade, more aggressive with poorer prognosis • 50% risk of developing bilateral cancer • BRCA 2: located on 13q12. • 40-85% risk of breast CA
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GIT J Club IBD- sexual dysfunction20.
GIT J Club IBD- pregnancy2020
GIT J Club IBD- pregnancy2020
Med 5th geriatrics20
Med 5th geriatrics20
GIT 4th abd wall pain
GIT 4th abd wall pain
GIT 4th endoscopy indications20
GIT 4th endoscopy indications20
GIT J Club from UEG Week 2018.
GIT J Club from UEG Week 2018.
Med j club dm antithrombosis19
Med j club dm antithrombosis19
Git 4th GC18.
Git 4th GC18.
GIT J Club IBS NEJM17.
GIT J Club IBS NEJM17.
GIT 4th indication for upper GI endoscopy.
GIT 4th indication for upper GI endoscopy.
GIT Cholestatic AI HBD 17
GIT Cholestatic AI HBD 17
GiIT 4th CRC 2017.
GiIT 4th CRC 2017.
Git j club colonoscopy mistakes.
Git j club colonoscopy mistakes.
GIT 4th ibd 2017
GIT 4th ibd 2017
GIT 4th IBS 2017
GIT 4th IBS 2017
Ppi seminar hiwa.
Ppi seminar hiwa.
Ppi symposium araz.
Ppi symposium araz.
Ppi symposium muhsin
Ppi symposium muhsin
Med j club pancreatic cancer nejm2010.
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Prepared by: Dr.
Mohammad Shaikhani. MBChB-CABM-FRCP.
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