logging in or signing up Soballe Breast Lecture abbrev chaoa Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 18 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: June 30, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Slide 1: Breast Cancer For Surgery Residents The Problem P.W. Soballe MD, FACS W.R. Drucker Professor of Surgery Uniformed Services University 1. Which ONE is TRUE ? : 1. Which ONE is TRUE ? ~ 100k new cases / yr 1:8 lifetime risk at age 38 ~ 25% DCIS Platypus: no milk 20% of breast in UOQ Slide 4: Modified Skin Appendage (Sweat) Gland Slide 5: 5 Slide 6: latissimus dorsi muscle inframammary ridge sternum 2nd rib clavicle 2. Which ONE is TRUE ? : Growth rate with size Improved imaging -> 0 mortality Mets unlikely to metastasize Adjuvant Rx proves micromets Fisher hypothesis original / novel 2. Which ONE is TRUE ? Tumor Doubling Time : Tumor Doubling Time 1 cell 2 4 8 16 100 billion cells 1 cm 100 days 200 days 300 days 400 days 8 years - visible on mammogram 10 years - palpable Window of Opportunity = “Sojourn Time” Gompertzian Growth : 104 Gompertzian Growth 1010 8 10 2 cm 1 cm 1 mm Years “Negative Cancer Control Window” : “Negative Cancer Control Window” 10,000 Cells = 1 mm 10,000 Cells - Angiogenesis Angiogenesis Metastasis NO “Early” Detection Slide 11: Talmadge J E , Fidler I J Cancer Res 70:5649, 2010 Slide 12: Anatomic spread: Breast-> Lymph Nodes -> Distant Treatment failure = inadequate surgery William Halsted, 1894 3. Which ONE is TRUE ? : 3. Which ONE is TRUE ? Most breast cancers depend on hormones ER = prognosis Estrogen: no incidence for years M’grams best in luteal phase Premarin: risk of breast cancer 5 Diseases : 5 Diseases 70%: “Luminal” A & B (ER pos) ?%: “Normal breast” (ER pos) 20%: Her2 amplified (20% also ER Pos) 10%: Basaloid (“triple negative”) When Good DNA Goes Bad: : When Good DNA Goes Bad: Germline Somatic Local mutation Mutation in egg or sperm All cells affected in offspring Parent Child Inherited in Cancer Pedigrees Sporadic & Not inherited 5. Which ONE is TRUE ? : 5. Which ONE is TRUE ? Breast cancers from stroma DCIS only within ducts Invasives : discrete margins Push stroma aside as they grow Pre-op chemo may not eliminate metastatic-competent cells You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
Soballe Breast Lecture abbrev chaoa Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 18 Category: Entertainment License: All Rights Reserved Like it (0) Dislike it (0) Added: June 30, 2011 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... Premium member Presentation Transcript Slide 1: Breast Cancer For Surgery Residents The Problem P.W. Soballe MD, FACS W.R. Drucker Professor of Surgery Uniformed Services University 1. Which ONE is TRUE ? : 1. Which ONE is TRUE ? ~ 100k new cases / yr 1:8 lifetime risk at age 38 ~ 25% DCIS Platypus: no milk 20% of breast in UOQ Slide 4: Modified Skin Appendage (Sweat) Gland Slide 5: 5 Slide 6: latissimus dorsi muscle inframammary ridge sternum 2nd rib clavicle 2. Which ONE is TRUE ? : Growth rate with size Improved imaging -> 0 mortality Mets unlikely to metastasize Adjuvant Rx proves micromets Fisher hypothesis original / novel 2. Which ONE is TRUE ? Tumor Doubling Time : Tumor Doubling Time 1 cell 2 4 8 16 100 billion cells 1 cm 100 days 200 days 300 days 400 days 8 years - visible on mammogram 10 years - palpable Window of Opportunity = “Sojourn Time” Gompertzian Growth : 104 Gompertzian Growth 1010 8 10 2 cm 1 cm 1 mm Years “Negative Cancer Control Window” : “Negative Cancer Control Window” 10,000 Cells = 1 mm 10,000 Cells - Angiogenesis Angiogenesis Metastasis NO “Early” Detection Slide 11: Talmadge J E , Fidler I J Cancer Res 70:5649, 2010 Slide 12: Anatomic spread: Breast-> Lymph Nodes -> Distant Treatment failure = inadequate surgery William Halsted, 1894 3. Which ONE is TRUE ? : 3. Which ONE is TRUE ? Most breast cancers depend on hormones ER = prognosis Estrogen: no incidence for years M’grams best in luteal phase Premarin: risk of breast cancer 5 Diseases : 5 Diseases 70%: “Luminal” A & B (ER pos) ?%: “Normal breast” (ER pos) 20%: Her2 amplified (20% also ER Pos) 10%: Basaloid (“triple negative”) When Good DNA Goes Bad: : When Good DNA Goes Bad: Germline Somatic Local mutation Mutation in egg or sperm All cells affected in offspring Parent Child Inherited in Cancer Pedigrees Sporadic & Not inherited 5. Which ONE is TRUE ? : 5. Which ONE is TRUE ? Breast cancers from stroma DCIS only within ducts Invasives : discrete margins Push stroma aside as they grow Pre-op chemo may not eliminate metastatic-competent cells