With almost 250,000 new cases in the United states and about 1,380,000 new cases throughout the world, breast cancer is the most common female malignancy, but it is also one of the most lethal tumors (almost 41,000 deaths estimated in the US in 2016) [1] [2]. Countries of the developing world exhibit a much higher mortality rate compared to the Western world, primarily because of a delayed diagnosis and late initiation of treatment [2] [3] [4] [5]. Studies have identified that between 3-8 months may pass from the onset of symptoms to the diagnosis in the developing world, compared to 30-48 days in Western countries [4]. As the majority of breast cancer tumors start as glandular tumors (adenocarcinomas), the term adenocarcinoma of the breast can be used to describe two main types of tumors - lobular and ductal carcinomas [6]. Numerous risk factors have been evaluated in the pathogenesis of breast cancer, but exposure to ionizing radiation, use of exogenous ovarian hormones, and excessive alcohol consumption have emerged as the most important ones [3] [7]. The main symptom of breast cancer is the presence of a lump in the breast, which may be accompanied by edema (either locally or in the armpit, suggesting dissemination of the tumor into the proximal lymph nodes) [6]. In addition, localized pain, inversion or retraction of the nipple, breast tenderness and discomfort are reported [6]. Constitutional complaints (fatigue, malaise, weakness) and distant pain (suggesting metastatic spread) are seen in more advanced stages of the disease [8].

• Axillary Lymphadenopathy

  Abstract Occult adenocarcinoma with clinically apparent axillary lymphadenopathy represents a challenging surgical problem. [ncbi.nlm.nih.gov]

  Needle biopsy Diff quik Images hosted on other servers: Ductal carcinoma, Figure A Poorly differentiated ductal carcinoma Images hosted on Flickr: 47 year old woman with 3 x 2 cm painless retroareolar mass and ipsilateral axillary lymphadenopathy, courtesy [pathologyoutlines.com]

  lymphadenopathy in more advanced cases breast skin edema with dimpling ( peau d' orange ) represents obstruction of the lymphatics by cancer Evaluation Fine needle aspiration can identify whether mass is solid or cystic can also retrieve sample for cancer [medbullets.com]

  Upon physical examination, the patient had bilateral discrete small cervical and axillary lymphadenopathy, and the breast examination was normal. Other systemic examination was not significant. [hindawi.com]

  Most patients present with a bulky palpable mass with axillary lymphadenopathy. [emedicine.medscape.com]

• Axillary Mass

  […] as a solitary, firm mass. 36. [slideshare.net]

• Pleural Effusion

  Thoracoscopic guided pleural biopsy is an effective and safe technique in patients with undiagnosed pleural effusion. [ccij-online.org]

  The patient experienced a relapse of right pleural effusion 2 years later and received multimodal treatment. Now, March 30, 2000, the patient is doing well without local recurrence, 8 years after her first admission. [ncbi.nlm.nih.gov]

  Respiratory complications (eg, atelectasis, pleural effusion, pneumonia) and cardiac complications (eg, cardiac arrhythmias) usually occur in the first postoperative days. [emedicine.medscape.com]

  •Myelosuppression,Generalized pain, asthenia, and headache. pleural effusions 141. [slideshare.net]

• Breast Mass

  Extensive evaluation revealed a 1-cm subareolar breast mass, with histopathological features identical to those of the orbital lesion. [ncbi.nlm.nih.gov]

  These are performed by inserting a needle into a breast mass and removing cells or tissues, for further examination. [dovemed.com]

  Detection Patients may present with a slow growing, solid feeling, movable mass for months, even years, prior to actual diagnosis. A common symptom of this cancer is intermittent pain and tenderness in the breast mass. [rare-cancer.org]

  Case Report A 74-year-old housewife was referred to the surgery ward on 10 th August, 2016 for the left breast radical mastectomy with clinical impression of the left breast cancer. She had the left breast mass and cutaneous ulcer. [pubs.sciepub.com]

  Signs and symptoms Characteristics Benign Malignant Breast mass – a dominant mass is a distinct mass that is asymmetric with the other breast. Benign findings are often associated with cysts, fibroadenomas, or fibrocystic changes. [pathophys.org]

• Nipple Retraction

  In advanced stages, one may observe the nipple retraction (due to the tumor infiltration of the lactiferous ducts), the "orange peel" aspect of the skin (due to lymphedema induced by tumor emboli in the lymphatics) and the immobility (fixation) of the [pathologyatlas.ro]

  retraction Gross images Contributed by Mark R. [pathologyoutlines.com]

  The nipple may be retracted or deformed. [ncbi.nlm.nih.gov]

• Bloody Nipple Discharge

  Papillary carcinomas are centrally located in the breast and can present as bloody nipple discharge. They are strongly estrogen receptor (ER) positive and progesterone receptor (PR) positive. [emedicine.medscape.com]

• Large Breast

  […] recurrence or contralateral breast cancer with breast conserving therapy  Prophylactic bilateral mastectomy for risk reduction may be considered •Large or central tumors in small breasts 109. [slideshare.net]

A detailed patient history and a complete physical examination are considered to be essential steps in the initial workup of breast cancer patients. During the patient interview, physicians should obtain key information about the onset and progression of symptoms and assess whether any of the mentioned risk factors (exposure to ionizing radiation, previous biopsies of the breast, use of oral contraceptives or post-menopausal hormonal supplements, and alcohol consumption are present [3]. A thorough family history, which may identify breast cancer or a history of other malignancies within the family, is also important [3]. The physical examination, however, is essential. A full inspection and palpation of both breasts is necessary in order to confirm the exact site of the mass, exclude enlargement of axillary lymph nodes, and evaluate the appearance of both the nipples (discharge, or anatomical changes such as inversion or retraction) and the surrounding skin (peau d'orange is a highly specific finding in advanced breast cancer where the skin resembles an orange peel) [3] [6]. Once a presumptive diagnosis is made based on clinical findings, imaging studies should be employed. Mammography is by many authors still regarded as the principal method for detection of lesions in the breast, and its use is indicated in all women who present with a palpable mass on physical examination [3] [9]. Additional procedures that can be used are magnetic resonance imaging (MRI) and ultrasonography, both used to assess the exact size and determine the tumor stage [3] [9] [10]. To determine the exact type of the tumor, a biopsy (either fine needle, core needle or excisional) is necessary [9] [11].

• Right Pleural Effusion

  The patient experienced a relapse of right pleural effusion 2 years later and received multimodal treatment. Now, March 30, 2000, the patient is doing well without local recurrence, 8 years after her first admission. [ncbi.nlm.nih.gov]

• Thrombocytosis

  Research output: Contribution to conference without publisher/journal › Poster › Research › peer-review Thrombocytosis as a poor prognostic factor in ovarian cancer Jørgensen, T., Teiblum, S. T., Paludan, M., Poulsen, L. Ø., Jørgensen, A. Y. [vbn.aau.dk]

• Pleural Effusion

  Thoracoscopic guided pleural biopsy is an effective and safe technique in patients with undiagnosed pleural effusion. [ccij-online.org]

  The patient experienced a relapse of right pleural effusion 2 years later and received multimodal treatment. Now, March 30, 2000, the patient is doing well without local recurrence, 8 years after her first admission. [ncbi.nlm.nih.gov]

  Respiratory complications (eg, atelectasis, pleural effusion, pneumonia) and cardiac complications (eg, cardiac arrhythmias) usually occur in the first postoperative days. [emedicine.medscape.com]

  •Myelosuppression,Generalized pain, asthenia, and headache. pleural effusions 141. [slideshare.net]

The combination of intraarterial infusion chemotherapy and radiotherapy plays a role in successful treatment of extensive local disease of the breast. [ncbi.nlm.nih.gov]

Breast cancer affects more than 1600 men per year in the United States, and treatment is currently based on the same guidelines used for the treatment of breast cancer in women. [nejm.org]

In: Breast Cancer Research and Treatment. 2016 ; Vol. 155, No. 1. pp. 37-52. [ucdavis.pure.elsevier.com]

These differences often affect prognosis. Tumor characteristics, such as hormone receptor status and HER2 status, also affect prognosis. Learn more about factors that affect prognosis. [ww5.komen.org]

No residual carcinoma was found, and all lymph nodes were free of cancer, indicating a good prognosis. A delay in diagnosis is common in men with breast cancer because patients and physicians do not recognize the clinical features. [nejm.org]

Excellent prognosis if pure Majority Grade 1 or 2 Mucinous carcinoma of breast Return to top of page [breastpathology.info]

Tubular breast cancer has an excellent prognosis. [hopkinsmedicine.org]

If you have breast cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. [cancer.ca]

This model is appropriate for studies of the etiology of ovarian hormone independent adenocarcinomas, for identification of therapeutic targets, predictive testing, and drug development. [ucdavis.pure.elsevier.com]

ICD-10-CM Codes › C00-D49 Neoplasms › C50-C50 Malignant neoplasms of breast › Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]

The etiology and risk factors of this variant of breast carcinoma is not fully identified. There is a need for discovery of unique biomarkers and targets for diagnosis and treatment of this variant of breast carcinoma. [mdanderson.org]

The differences between the US and British reported frequencies may be cultural ("environmental expectations") and due to the heterogeneity of ADHD (ie, the many etiological paths to get to inattention/distractibility/hyperactivity). [emedicine.medscape.com]

(Etiology) The exact cause of development of Mucinous Carcinoma is currently not clearly known. Studies have shown that such tumors may be caused by hormonal influence Certain gene mutations have also been reported in the tumors. [dovemed.com]

Introduction Epidemiology breast cancer is the most common cancer and second most common cause of death in adult women Risk factors BRCA1 and BRCA2 mutations associated with multiple / early onset breast and ovarian cancer other genetic relationships [medbullets.com]

Definition Epidemiology About 2.5% of all breast carcinomas are of micropapillary type 1. Patients are adult, with a mean age of about 50 years 1. [e-immunohistochemistry.info]

These specific tumor types are defined by their morphology, but are also linked to particular clinical, epidemiological, and molecular features. [karger.com]

NCI, Surveillance Epidemiology and End Results Stat Fact Sheets [On-line information]. Available online at http://seer.cancer.gov/statfacts/html/breast.html. Accessed on 6/8/08. (2006 May 23). The TAILORx Breast Cancer Trial. [labtestsonline.it]

Breast Cancer Pathophysiology Breast cancer is a malignant tumor that starts in the cells of the breast. Like other cancers, there are several factors that can raise the risk of getting breast cancer. [news-medical.net]

Osteoblastic metastases share a similar pathophysiology with osteolytic metastases, in which the bone microenvironment enhances the local growth of tumor cells, and tumor cells localized to bone in turn secrete factors that stimulate osteoblast activity [hindawi.com]

Types of invasive breast carcinoma include ductal, lobular, and mixed. [5] Pathophysiology To date, the basis for breast carcinoma as the most common primary metastatic process to the orbit is unclear. [eyewiki.aao.org]

The pathophysiology of mitochondrial cell death. Science. 305, 626-629 (2004). Casellas, P., Galiegue, S., Basile, A. S. Peripheral benzodiazepine receptors and mitochondrial function. Neurochem. Int. 40, 475-486 (2002). Mathupala, S. [jove.com]

Pathophysiology The pathology of ADHD is not clear. [emedicine.medscape.com]

[…] and early detection of cervical cancer: American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. [nccn.org]

The Bottleneck for Cancer Prevention and Early Detection One of the critical barriers to developing new approaches for cancer detection and prevention is the lack of understanding of the key molecular and cellular changes that cause cancer initiation [cancerpreventionresearch.aacrjournals.org]

and Complications Prognosis lymph node involvement is the single most important prognostic factor TNM staging extranodal metastases has more significance than lymph node metastasis Prevention mammography effective screening tool except in young woman [medbullets.com]

Though not considered hormone therapy, Herceptin is another drug that helps prevent cancer recurrence. Called a biologic, Herceptin attaches itself to cancer cells and prevents them from receiving growth signals. [healthcentral.com]

Both drugs have potential side effects; including being at a higher risk for blood clots Preventative mastectomy: Prophylactic mastectomy, a procedure to surgically remove healthy breasts, is another possible preventative option for women, at a high risk [dovemed.com]

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