培训资料--乳腺癌中山大学肿瘤医院20101019.ppt

Breast Cancer;Jemal A., et al. CA Cancer J Clin 2010; 60:277-300;Jemal A., et al. CA Cancer J Clin 2010; 60:277-300;Breast cancer is more frequently diagnosed in affluent countries and the death rate is higher in developing countries;Recent Decrease in UK and USA Breast Cancer Mortality at Ages 50-69 Years;Functional Anatomy ;;Blood Supply ;The veins of the breast and chest wall ;Neural anatomy of the breast;The lymphatic drainage of the breast;The lymph node groups;Risk factors - unchangeable ;Risk factors - unchangeable/contd.;Risk factors associated with lifestyle;Factors with uncertain, controversial or unproven effects on risk of developing breast cancer;Hereditary Breast Cancer;Histopathology of Breast Cancer;Carcinoma In Situ ;Ductal carcinoma in situ (DCIS) cribriform type;Lobular carcinoma in situ (LCIS) ;Invasive Breast Carcinoma;Invasive ductal carcinoma;Blood vessel invasion;Microinvasive breast cancer （微侵）;Diagnosing breast cancer ;;Clinical Presentation;Symptoms that may indicate breast cancer;A breast lump is most often the clinical problem that causes women to seek treatment and remain the most common presentation of breast carcinoma. 65% of breast cancer cases. Other less frequent presenting signs and symptoms of breast cancer include (1) breast enlargement or asymmetry; (2) nipple changes, retraction, or discharge; (3) ulceration or erythema of the skin of the breast; (4) an axillary mass; and (5) musculoskeletal discomfort. However, some of women presenting with breast complaints have no physical signs of breast pathology. Breast pain usually is associated with benign disease.;Dimpling （酒窝征）: skin retraction, tumors deep within the substance of the breast that involves the Cooper’s ligaments Peau d’orange （桔皮征）: edema of the breast. Usually obstruction of the dermal lymphatics with tumor, extensive axillary LN involvement related met tumor, primary disease of the axillary nodes, axillary dissection. (also after irradiation of the