外科学-各论英文课件：Breast Disease乳腺疾病.pptx

Breast Disease;Breast cancer A tumour through time ;3;Most common cancer among women Vary considerably between countries Relatively lower in China;Breast Cancer: Current Status in China ;Female Malignant Tumors: Constituent Ratio of New Cases in Shanghai, 2004 ;Time Trends of Incidence and Mortality: Increase Continuously，1973-2004;Changes in Initiative and Promotive Factors;What Could Influence Breast Cancer Incidence? ;Life Style and Dietary Pattern ;Reproductive History;Menopausal Status;Breast diseases;Anatomy;Anatomy;Anatomy;Level II LN lying directly beneath the pectoralis minor muscle Level III Medial to the medial border of the pectoralis minor muscle and extending up to the apex of the axilla;lymph;Subcutaneous lymphatic communication left→right Lymphatic plexus on the rectal sheath →falciform ligament→liver;Intercostobrachial nerve a sensory nerve supplying the underarm skin Long thoracic nerve of Bell a motor nerve to the serratus anterior and subscapularis muscles Thoracodorsal nerve a motor nerve to the latissimus dorsi adjacent to its accompanying artery and veins ;;; Examination ;Clinical Breast Exam (CBE) in China;Inspection Overall inspection symmetry, size, shape, skin color, venous pattern, lump, local dimpling, retraction; Nipple excoriation, inversion, discharge, edema and redness ; Palpation Gentle palpation, quadrant by quadrant Skin Mass ;Lymph node;Mass is the primary symptom which accounts for 80% breast cancer. A lump or a thickening in the breast or in the armpit Number size consistency mobility;Character of the discharge is significant Milky, serous, or green-brown discharge Bloody discharge;Nipple itching Ulcers, desquamation, Exudate, bleeding, Erosion;Redness Edema Peau d’orange or pig-skin Dimples;Tumor metastasis can lead to changes in the lymph nodes Position Size Mobility Surface Merge Number;Cystic hyperplasia Fibroadenoma Intraductal papilloma Mastitis Cy