Ο ΔΙΗΘΗΤΙΚΟΣ ΚΑΡΚΙΝΟΣ ΤΟΥ ΜΑΣΤΟΥ.
Risk factors
Sex. The female to male ration of breast cancer is 100:1
Relatives. The risk factor of breast cancer depends of a) the degree of relatives b) the number of relatives, c) their age of diagnosis and d) if the cancer was unilateral or bilateral.
Prior breast cancer . The prior BC is a significant risk factor of developing BC to the contralateral breast, with an incidence of 0.5-1% per year of follow up.
Proliferative disease. Low risk disease are the hyperplasia without atypia, papilloma, and sclerosing adenosis. Moderate risk are: atypical lobular or ductal hyperplasia. High risk factor is the LCIS.
Duration of menstruation. Women who menstruate over 30 years are at high risk. So the menarche before 13 and the menopause after 50 are risk factors.
Pregnancies. The age of first pregnancy and not the numbers of pregnancies protect the women. Woman with first pregnancy before 19 has half risks factors than the nulliparous, The risk is the same in the age 30-35 and higher above 35 years.
The exogenous replacement postmenopousal therapy increase the risk factor but not overweigh the benefits as protection of coronary artery disease, stroke, and bone density.
PATHOLOGY TYPE
- Infiltrating ductal carcinoma (75%) . Metastasize to axillary lymph nodes
- Infiltrating lobular carcinoma (10%). Multicentricity, metastasize to menignes and serosa surface.
- Tubular carcinoma
- Medullary carcinoma
- Mucinous or colloid carcinoma.
STAGING
T1a: The greatest dimension of tumor is less than 0.5cm
T1b: The tumor is more than 0.5 cm but less than 1cm
T1c: The tumor is more than 1cm but less than 2cm
T2 :The tumor is more than 2cm but less than 5cm
T3: More than 5cm
T4: tumor of any size with direct extension to the skin or chest wall
N0: No regional lymph nodes metastases
N1: Metastasis to movable ipsilateral lymph nodes
N2: Metastasis to ipsilateral axillary lumph nodes fixed to one another or to other structure.
N3: Metastasis to ipsilateral internal mammary lymph nodes.
M0: No metastses
M1: Distant metastases including to ipsilateral supraclavicular lumphs