Post on 29-Sep-2015
description
SURGERY DEPARTMENT FACULTY OF MEDICINE YARSI UNIVERSITY JAKARTA 2011
Risk FactorsMenarche , 11 years oldNulliparaNon breast feedingHormonal therapyHigh fat diet, alcoholPositive pedigreePrevious benign breast lesion Ovarium tumor Radiotherapy
ANAMNESIS
The chief complain The risk factors The metastasis symptom and sign
MASSFixedUnclear borderUn smooth surfacePeau de orangeDimplingUlcusSatellite nodule
AXILLARY
Palpation of lymph nodes
Mammography
Ultrasonography
MRI
ClinicMammographyFNAB
Concordan benignaConcordan malignaInconcordan
TNM system
TTxT0Tis, DCIS, LCIS
T1 T5cm
T4 a. chest wallb. skinc. bothd. mastitis carsinomatosa
NxN0N1 axilla, mobileN2 axilla, fixedN3a. infraclaviculab. Axilla + mammaria internac. supraclavicula
Mx M0no distance metastasesM1 distance metastases
Ro thoraxUSG abdomenOther clinical picture
Grading
G1 Low gradeG2 IntermediateG3 High grade
SURGERY
Breast Conserving TherapyModified Radical MastectomySimple Mastectomy
RADIOTHERAPY
CHEMOTHERAPYCMFCEFCAFTaxol + DoxoCapecitabine
AdditiveTamoxifen
AblativeBilateral oophorectomyOperativeRadiation
GeneticBiomolecular
P53BRC A1BRC A2HER2/NEUC-erbB-2Cathepsin-D