cancer - naresuan university
TRANSCRIPT
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Cancer
Cancer Carcinoma • Lobular carcinoma • Ductal carcinoma • In situ • invasive / infiltrating Sarcoma
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Carcinoma Risk factors : • familial history • fibrocystic disease • early menarche / late menopause • late birth of first child • nulliparous
• exogenous hormone
Carcinoma in situ Ductal carcinoma in situ (Intraductal carcinoma) Lobular carcinoma in situ • nonpalpable lesion : mammography, incidental finding • mass : periductal fibrosis, FCD • nipple discharge
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Ductal carcinoma in situ
Invasive carcinoma • Invasive ductal carcinoma (Infiltrating duct carcinoma) • Invasive lobular carcinoma
• Tubular carcinoma • Colloid carcinoma • Medullary carcinoma
• Metaplastic carcinoma
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Invasive ductal carcinoma
Colloid carcinoma
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Invasive lobular carcinoma
Carcinoma behavior : • direct invasion skin, chest wall • lymphatic spread axillary lymph nodes internal mammary chain • hematogenus spread bone, lung, liver, ovary
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Carcinoma
Invasive ductal carcinoma
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Invasive ductal carcinoma
Invasive ductal carcinoma
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Invasive ductal carcinoma
Lymphatic drainage
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Paget’s disease • epidermal invasion by ductal
cancer cells of the nipple • nipple lesion : chronic eczema • underlying ductal carcinoma
Paget’s disease
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Investigations • physical examination • mammography • fine needle aspiration • core needle biopsy • excisional biopsy • incisional biopsy
mammography
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+
abnormal mammography
FNA : normal ductal epithelium
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FNA : Invasive ductal carcinoma
Treatment • surgery : modified radical mastectomy : conservative operation • radiotherapy • chemotherapy • hormonal therapy
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Estrogen receptor : Immunohistochemical study
Response to hormonal therapy
0
10
20
30
40
50
60
70
80
ER+, PR+ : 77% ER-, PR+ : 46% ER-, PR- : 11%
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