(内分泌系统）乳腺疾患知识介绍.pptVIP

Disorders of the Breast;case;1 Anatomy;Breast ;;Cooper lig;2 Examination of breast;Self-examination of breast（1）;Self-examination of breast（2）;Self-examination of breast（3）;Self-examination of breast（4）;Self-examination of breast（5）;3 Cancer of breast;Cancer of beast;6. epidemiology;Risk factors include;Noninvasive breast cancer (in-situ);Invasive breast cancer; spread of breast carcinoma;; spread of breast carcinoma;clinical presentation;Typical findings;Typical findings; ;change of surface： skin dimpling nipple retraction, drift malformations;dilated superficial venous engorgement and reddening;ulceration;ulceration;Paget’s carcinoma of breast;Paget’s carcinoma of breast;Inflammatory breast carcinoma;Inflammatory breast carcinoma;6 Diagnosis of breast carcinoma;mammography;irregular or lobular, ill-defined， high dense in center, some with spiky. Skin dimple over carcinomas or nipple retract. ;Character of mammography of breast cancer;Sometimes coarser calcification is found close to masses. Especially when there are more than 15 calcification/cm2 , the mass must be cancer. ;Ultrasonography;MRI;aspiration;biopsy;differential diagnosis;staging of breast cancer;T (size and extent of primary tumor) ;N （ipsilateral axillary lymph nodes）;M （distant metastases）;clinical staging;therapy;最早描述乳腺癌（公元前460年-前377年 ）（最早是BC3000-2500埃及人） 原发包块的切除(公元1世纪) 局部周围组织的切除（皮肤、腺体，脂肪、肌肉10-16世纪 ） 乳房全切术（19世纪之前） ;复发率、死亡率仍然很高 把可能转移的和复发的地方都尽可能地切除，提高生存 1898年发明根治术 ;根治术 ;改良根治术 ——胸大肌不切除;改良根治术 ——胸大肌不切除;● Modified mastectomy;surgical therapy;chemotherapy;Indications for radiotherapy： axillary lymphatic metastasis parasternal lymphatic metastasis (confirmed by pathology） primary tumor T3(5 CM) lesion of local recurrence or bone metastases breast conserving surgery ;endocrine therapy; 4 Benign disorders of breast;4.1 infection of the breast;pathology;clinical presentation Local sign of acute inflammation;clinical present