logging in or signing up Soballe Breast Lecture abbrev chaoa Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel 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: 24 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.