乳腺疾病课件-英文版(1).ppt

乳腺疾病课件-英文版 AnatomyModified sweat gland between the superficial and deep layers of the chest wallCooper’s LigamentFibrous band of tissue AnatomyDuctsTerminal ductulesMilking forming glandsLobule AnatomyAxillary lymph nodes defined by pectoralis minor muscleLevel 1 – lateralLevel 2 – posteriorLevel 3 – medialLong Thoracic NerveSerratus anteriorThoracodorsal NerveLatissimus DorsiIntercostalbrachial NerveLateral cutaneous Sensory to medial arm axilla Clinical ExamInspectionSkinSymmetryMassesPalpableGlandAxilla, Supraclavicular spacesNipple-areola complex Breast CystsFluid-filled 1 out of every 14 women50% multiple and recurrentHormonally influencedNeedle aspiratedBreast Mass Breast Cyst FibroadenomaStromal and epithelial elementsMost common in women 30yoFirm, solitary tumorsMultipleIncrease in sizeManagementBiopsyExcisional biopsyBreast Mass‘’ Fibroadenoma MastitisGeneralized cellulitis of the breastAscending infection ?subareolar ductscommonly occurs during lactationStaph. aureusErythema, pain, tendernessBreast Infections MastitisTreatmentAbxContinue to breast feedClose follow-up AbscessBreast tissueTreatmentAbxNeedle aspirationIncision and drainageBreast Abscess Breast Cancer 2. Etiology 病因Hormonal influence(激素影响):Long duration of reproductive life(育龄的长时间持续)Nulliparity([,n?li‘p?r?ti]未产妇)Late age at first child(老龄生育)Functioning ovariantumor(卵巢肿瘤影响) Fibrocystic disease(乳腺纤维囊性病) Radiation exposure(射线照射) Obesity(肥胖) Genetic predisposition遗传倾向) 3. Pathological typing 病理类型Noninvasive breast carcinomaductal carcinoma in situ, lobular carcinoma in situ, Paget’s diseaseEarly invasive breast carcinomaSpecial types of invasive breast cancerpapillary, medullary, tubular, mucinousOrdinary types of invasive breast cancerinvasive ductal, invasive lobular Others 4. 转移途径(1). Infiltrate, local invation 直接浸润(2). lymphatic metastasis 淋巴转移经胸肌外缘--同侧腋窝--锁骨上--胸导管经胸骨旁--锁骨上--胸导管(3). hematogenous metastasis 血行转移 along inter-fascial spacealong ductulesLocal invasionInvading Cooper’s ligaments