单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Breast Carcinoma,Anatomy,Epidemiology:,10%,17.1/10 28/10 46/10,1.2 m world wide,6%develop cancer of the breast in their lifetime.,50,000 to 70,000 new cases USA,Risk Factors for Breast Cancer,Major Minor,Gender(femalemale)Early menarche,Age Late minopause,Family history(mother,sister,or Obesity,daughter with premenopausal Low-dose radiation,or bilateral cancer),Personal history of contralateral BC,Nonivasive carcinoma(ductal or lobular,carcinoma in situ),Benign proliferative changes with atypia,Pathology of Breast Cancer,Noinvasive,1,、,Ductal Carcinoma in situ(DCIS),，,intraductal,2,、,Lobular Carcinoma in situ(LCIS),Invasive,1,、,Infiltrating ductal carcinoma,:,this is the most common malignant tumor in the breast recognized after biopsy.,2,、,Invasive Lobular carcinoma:,Pagets disease of the nipple,Diagnosis of Breast Mass:,history and physical examination,Risk factors for breast cancer:,3 fine-needle aspiration,4 breast imaging:,5 ultrasonography,thermography,computed tomography(CT),magnetic resonance imaging(MRI),mammography.,Staging Breast Cancer,T1 tumor more than 2 cm or less in greatest dimension,T2 tumor more than 2 cm,but not more then 5 cm in,greatest dimension,T3 tumor more than 5 cm in greatest dimension,T4 tumor in any size with direct extension to chest wall or skin,No no regional lymph node metastasis,N1 metastasis to movable ipsilateral axillary lymph node,N2 metastasis to ipsilateral axillary lymph nodes that are,fixed to one another or to other structures,N3 metastasis to ipsilateral internal mammaryl lymph node,Mo no distant metastasis,M1 distant metastasis(includes metastasis to ipsilateral,supraclavicular lymph node),Surgical Procedures Past and Present,In 1894,Halsted,Radical and Extended Radical mastectomy:,Modified radial mastectomy:,Patey:,Auchincloss:,Adjuvant chemotherapy for operable breast cancer:,1),Adjuvant chemotherapy for lymph node-positive patients,2)Adjuvant chemotherapy for lymph node-negative patients,Hormonal therapy for breast cancer,1)Steroid hormone receptors,2)Adjuvant hormonal therapy for operable breast cancer,Recommendations for Adjuvant Treatment,Menopausal Axilliary Tumor Recommended Treatment,Starus Nodes Characteristics,Premenopausal Positive Favorable or Un,Combination chemotherapy,Premenopausal Negative Favorable No data to support adjuvant,Premenopausal Negative Unfavorable Combination Chemotherapy,Postmenopausal Positive Favorable TamoxifenChemotherapy,Postmenopausal Positive Unfavorable Chemotherapy Tamoxifen,Postmenopausal Negative Favorable No data to support adjuvant,Postmenopausal Negative Unfavorable No data to support adjuvant,Favorable tumor characteristic include size2 cm,Er or PgR positive,nuclear and histologic grade good(1 or 2),