DUCTAL
Triple Assessment done if is suspected/2 week wait criteria met. CARCINOMA
-
cancer
MAMMOGRAPHY
1.
History Examination
-
Ultrasound
2.
Mammogram imaging
or
3.
Biopsy Luma Core Fine Needle I
of or
Ultrasound:used in women 35and men due to denser breasttissue.
younger
Also used in pregnant/breastfeeding to avoid radiation exposure.
·
women
used Red
Mammography:X-Ray in older women: 35.
Flags:
Also used for from 50-71.
screening 3
·
every years age
Peau
d'orange/dimpling
-
Malignant
Painless, Tethered, Irregular lump
Disease
-
-
Retracted nipple
Bloody Discharge
-
Types: weight loss, night sweats, lymph
-
·
Ductal:affects ducts. Most common type.
mammary
Risk Factors:
Ductal Carcinoma in situ (DCIS): ·
prolonged destrogen exposure,
Cells contained within ducts. oestrogen promotes
Non-Invasive, Pre-malignant. as breast growth
·
·
seen as Calcification on
imaging. and ... increases mutation chance.
Less common
subtype
·
Invasive Ductal Carcinoma (IDC/NST): FH
-
·
Progression of DCIS, and can metastasise. Stroma invaded. -
BRCA1/2, HER2 mutation
·
more common
subtype
-
Early menarche, late menopause
HRT
-
·Lobular:affects lobule combined Pill
glands.
-
pregnancies
-
no
·Other Cancers:Tubular, Medullary, Mucinous, Paget's, etc.
Obesity
-
common metastasis:
Management: Spine, Brain, liver, lungs. Pathogenesis:
Some ER+tive,
·
cancers are
done with sentinal while others HER2 tive.
staging de biopsy in axilla.
·
no are
node clearance done if biopsies
Axillary positive. Cancers that ER and HER2-five
·
are are
have worst
Risk of lymphoedema. prognosis.
wide local excision (WLE) Radiotherapy
-
+
-Mastectomy
Hormone Therapy:used in ER+tive disease
-
e.g. Tamoxifen (SERM)
Anastrazole (Aromatase inhibitor)
Goserelin (GnRH analoquel
-
Herceptin, Ab used in HER2 tive disease.