乳腺疾病-英文版教案分析.ppt

Hypoechoic, no acoutic transmission * * 主要与雌激素 estrogen 有明显关系 雌性激素与雌性激素受体结合-- 进入细胞核 nucleolus -- 作用于DNA的合成-- 产生生物效应 * 1 .非浸润性癌:导管内癌,小叶原位癌--属早期. 2 .早期浸润性癌: 3 .浸润性特殊癌 4 .浸润性非特殊癌 5 .其他罕见癌 * * * Dimple: 酒窝征 局部 Peau d’orange 1 乳房肿块 mass, lump, neoplasm 2 皮肤凹陷 retraction 3 乳头牵扯偏向或内陷 4 皮肤桔皮样变 5 盔甲状癌 6 乳癌破潰 ulcer * 淋巴结肿大 * * Local protrusion assymetricity of Bil. Breasts change in shape assymetric breast change in shape Change in skin-- Delle and dimple sign Delle: visible skin retraction dimple sign: pinched skin retraction invasion of Cooper’s ligaments and adjacent adipose incomplete fixation of skin Change in skin-- orange-peel sign thickening of skin dermal edema induced by invasion of lymphatic vessels Change in nipple-- nipple retraction and inversion differentiated from congenital nipple retraction invasion of mammary ducts Change in nipple areola-- eczematoid change Paget’s disease low malignant degree, slow development 90% accompanied by invasive cancer Huge mass and ulceration-- locally advanced carcinoma 20% of all cases 50% in elderly women 70 yr Inflammatory breast cancer high malignant degree, fast development, poor prognosis younger women 5.3. Clinical presentation distal metastasis 癌转移 Axillary Lymphadenectasis 腋下LN肿大 Bone metastasis 骨痛 local pain, fracture Liver metastasis 肝大 liver enlargement, jaundice Lung metastasis 胸痛 Chest pain, dyspnea Clinical presentation axillary palpated movable, ipsilateral axillary nodes fixed or fused ipsilateral axillary nodes ulcerative ipsilateral axillary nodes Mammography Screening tool Age of 40 Estimated reduction in mortality 15-25% 10% false positive rate Densities calcifications Ultrasound Benign Pure and intensely hyperechoic Elliptical shape wider than tall Lobulated Complete tine capsule Malignant Hypoechoic, spiculated Taller than wide Duct extension microlobulation Diagnosis --biopsy Fine needle biopsy Cytology 70% accuracy Core needle biopsy Histo