Medicine an Surgery notes

Apr 24th, 2015
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BREAST CANCER: DIAGNOSIS AND MANAGEMENTIntroduction-It is the commonest cause of cancer death in women- It accounts for 6% of all female deathDIAGNOSISDiagnosis is by Triple Assessment A)Clinical Evaluation - Lump and regional nodes B)Imaging (ultrasound <35 years old or mammography >35 years old) C) Cytology or Histology HistoryPresenting complaints-Painless breast lump more than 70% of patients.-Some present with painful breast lumps due to the following reasons1) Ishaemic changes and necrosis2) Inflammatory carcinoma of breast3) Lympedema of the breast4) Local invasion into intercostals spaces and muscles plus nerves5) Superimposed infection-Mass rapid growth -Duration of the mass-Changes with menses -Nipple discharge-Ulceration and other skin changes-irritation and eczematous skin change- Rarely, patients show signs of metastatic disease without a palpable mass in either breast back pain ,cough with hemoptysis.Advanced disease symptoms-Chronic cough-lung metastasis-Weight loss, anorexia and generalized fatigue-Upper limb swelling-axillary lymph nodes involvement with lymph edema-Back pain-metastasis to the back ,Yellowness of eyes-History of predisposing factors1) Breast cancer in the contra lateral breast2) Benign breast disease with hyperplasia and atypia ,Benign breast disease with multiple papilomas3) Advancing age>50 years.(Most ca 35-45 years)4) Family history of breast cancer, GIT or ovarian cancer5) Nulliparity6) Early menarche<1

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