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Overview
Epidemiology Risk Factors Prevention Early diagnosis
Women 713,220
27% 14% 10% 6% 4% 4% 4% 3% 3% 3% Breast Lung & bronchus Colon & rectum Uterine corpus NHL Melanoma of skin Thyroid Kidney & renal pelvis Ovary Pancreas
Melanoma of skin 5%
19%
22%
9%
6% 4% 4%
9%
6% 5% 4%
Esophagus
Urinary bladder NHL All other sites
4%
3% 3% 25%
3%
3% 2% 2% 25%
Leukemia
Uterine corpus Liver & bile duct Brain/ONS All other sites
Risk
1 in 3
Breast
Lung & bronchus Colon & rectum Uterine corpus
1 in 8
1 in 16 1 in 20 1 in 40
Non-Hodgkin lymphoma
Urinary bladder Melanoma Ovary
1 in 53
1 in 84 1 in 58 1 in 72
Pancreas
Uterine cervix
1 in 75
1 in 145
Includes invasive and in situ cancer cases Statistic for white women.
Source: DevCan: Probability of Developing or Dying of Cancer Software, Version 6.3.0 Statistical Research and Applications Branch, NCI, 2008. http://srab.cancer.gov/devcan
5 4.31
3.42
2.67
1.48
0.39
30-40
40-50
50-60
60-70
70-80
According to UICC and World Health Report 2005 47% of newly diagnosed breast cancers in Pakistan are already in advanced stage.
Risk Factors
Risk Factors do not cause breast cancer but are associated with an increased chance of getting breast cancer The number one risk factor for breast cancer is being a women Age is a risk; the chance of getting breast cancer increases with age
RISK 1 out of 2,000 1 out of 233 1 out of 53 1 out of 22 1 out of 13 1 out of 9 1 out of 8
Risk Factors
Controllable Alcohol drinking Being overweight Never having children 1st child >30yrs of age Hormone Replacement Birth control pills (very slight)
ACS Breast Cancer Facts 2001-02
Uncontrollable Getting older First degree relative with breast cancer A previous breast biopsy showing atypical changes
Risk Factors
Controllable Uncontrollable Being exposed to Being young (<12) at the large amounts of time of menses radiation Starting menopause after age 55 Having an inherited mutation in the breast cancer genes (BRCA 1 or 2)
ACS Breast Cancer Facts 2001-02
EAT HEALTHY
EXERCISE
Screening Recommendations
A.C.R, A.M.A and A.C.S all recommend :-
Beginning at age 20, monthly self examination and clinical examination by a health care provider at least every three years Base line at age 35-40 years and then annual mammography Earlier screening for high risk women
Early Detection
Self breast examination.
Mammography
A special kind of X-Ray of the breasts done by a dedicated machine. A non invasive test. Involves insignificant radiation hazard. Takes only about half an hour. ACR recommends screening mammogram every year starting at age 40. Cancers below 1cm can be detected.
Mammography
Always bring previous mammography films and imaging reports whenever you come for a mammogram. Do not wear talcum powder or any deodorants as they cause artifacts.
Indications of Mammography
To assess signs and symptoms of breast disease such as lump, nipple discharge, change in shape of breast or mastalgia.
Indications of Mammography
Preoperative mammogram is done To establish multifocality and to plan type of surgery. To examine contralateral breast.
Breast Ultrasound
It is used as a prime modality to investigate women with breast symptoms who are younger than 40. It is safe and very informative but always should be done by trained Radiologist as breast ultrasound is a super speciality and cannot be performed on ordinary ultrasound units.
Breast Ultrasound
Can only be done with high resolution dedicated ultrasound units. Safe test with no ionizing radiation involved. Should only be performed by trained radiologists who are experienced in doing breast sonography.
Indications of Ultrasound
Mostly complimentary to mammography. Helps in further charachterizing the type of lesion whether solid or cystic.
Indications of Ultrasound
Also helps in predicting whether a lesion is benign or malignant. Primary modality in women below thirty five years of age, pregnant or lactating women.
Tissue Diagnosis
Needle biopsy.needle tests are essential to diagnose cancer sometimes image guidance is used.Biopsy is a technique in which a small amount of breast tissue is taken and examined under the microscope. General misconceptionneedle biopsies DO NOT help in spreading the tumour.
It includes: Fine Needle Aspiration Fine needle aspiration (FNA) is a percutaneous ("through the skin") procedure that uses a fine needle and a syringe to sample fluid from a breast cyst or remove clusters of cells from a solid mass. Core Needle Biopsy Core needle biopsy is a procedure that removes small but solid samples of tissue using a hollow "core" needle.
Early Detection
THE EARLIER A CANCER IS DETECTED THE MORE ARE THE CHANCES OF CURE.
Breast cancers less than 1.5cm in size have a cure rate of about 94%.
Breast Cancer
Any questions?