A lecture.

1. 1
Breast Cancer
Awareness Forum
Roel S. Tolentino, MD, MBA, FPCS, FACS, FPSO, FPSGS, FMOSP
General Surgery – Surgical Oncology
Past President- Philippine Society of Oncology
Professor of Surgery IV

2. Memorial Sloan Kettering Cancer Center (NYC)
University Hospitals of Columbia University and Cornell Medical College
(NYC)
MD Anderson Cancer (Texas)
Beijing Cancer Hospital (China)
Chongqing Medical University (China)
Suining Central Hospital (China)
De La Salle University – BS. Biology;
Medicine
Manila Med – General Surgery
SLMC – Surgical Oncology
Ateneo GSB - MBA
Prof. Roel Tolentino, MD, MBA

3. 3
Breast Cancer
Awareness Forum
Roel S. Tolentino, MD, MBA, FPCS, FACS, FPSO, FPSGS, FMOSP
General Surgery – Surgical Oncology
Past President- Philippine Society of Oncology
Professor of Surgery IV

4. 4
BREAST CANCER
- Most common cancer in
the Philippines!
(Metro Manila and Rizal registry)

5. 5

6. 6

7. 7

8. 8
Anatomy

9. 9
Anatomy

10. 10

11. 11
Mastitis

12. 12
Intraductal papilloma

13. 13
Phyllodes Tumor

14. 14
Galactorrhea (paglabas ng gatas)

15. 15
Hematoma (pasa)

16. 16
Fibrocystic
changes

17. 17
Fibroadenoma and Cyst

18. 18
Breast Self Examination

19. 19
Breast Self Examination

20. 20
Breast Self Examination

21. 21
Breast Self Examination

22. 22
Breast Self Examination

23. 23
•
Breast Self Examination

24. 24

25. 25
Breast Clinical Examination

26. 26
Physical Examination

27. 27

28. 28

29. 29
Palpation in circular
or radial fashion

30. 30
Diagnostic Tests
•Mammography
•Ultrasound
•Needle Aspiration Biopsy
•Excision Biopsy
•Magnetic Resonance Imaging (MRI)

31. 31
Mammography

32. 32
Mammography

33. 33
Diagnostics
•Mammography
Cranio-caudal view

34. 34
Diagnostics
•Mammography
Oblique View

35. 35
Mammography

36. 36
Mammography

37. 37
Mammography

38. 38
Digital Mammography

39. 39

40. 40
Ultrasound

41. 41
Tomosynthesis

42. 42
BIOPSY

43. 43
Needle Biopsy

44. 44Technique of Fine Needle Aspiration

45. 45

46. 46

47. 47

48. 48

49. 49

50. 50

51. 51

52. 52
Excision Biopsy

53. 53

54. 54
Open Surgical
Biopsy
Percutaneous
Biopsy
Biopsy

55. 55
Magnetic Resonance Imaging

56. 56
Magnetic Resonance Imaging

57. 57

58. 58
Risk Factors for Breast Cancer
• Gender
• Aging
• Genetic risk factors/Family history
• Personal history of breast cancer

59. 59
Risk Factors for Breast Cancer
• Race
• Previous abnormal breast biopsy
• Previous breast radiation
• More menstrual periods

60. 60
Risk Factors for Breast Cancer
• Not having children
• Hormone replacement therapy
• Alcohol
• Obesity and high-fat diets
• Less physical activity

61. 61
Early detection for breast cancer:
• 20 years or older
– Breast self examination (BSE)
monthly.
• 20-40 years old
– BSE monthly.
– Physician breast examination every
3 years.

62. 62
Early detection for breast cancer:
• An initial mammogram between the
age of 35-40 years.

63. 63
Early detection for breast cancer:
• 40-50 years old
– BSE monthly.
– Annual physician breast examination.
– Periodic mammography every year or
two as determined by personal history
and doctor's recommendation.

64. 64
Early detection for breast cancer:
• Over 50 years of age
– BSE monthly.
– Annual mammography and physician
breast examination.

65. 65
Signs of Cancer
(Mass)

66. 66
Signs of Cancer
(Nipple Retraction)

67. 67
Signs of Cancer
(Distortion)

68. 68
Signs of Cancer
(Peau d’orange)

69. 69
Signs of Cancer
(Distortion, Nipple Retraction)

70. 70
Signs of Cancer
(Bloody Nipple Discharge)

71. 71
Signs of Cancer
(Scaling)
Paget’s Disease

72. 72
Signs of Cancer
(Asymmetry)

73. 73
Redness

74. 74
Signs of Cancer
(Ulceration)

75. 75
Breast Cancer with Ulcerations

76. 76

77. 77

78. 78

79. 79
Operations for Breast Cancer

80. 80

81. 81
Locally Advanced Breast Cancer
After neoadjuvant therapy

82. 82
Modified Radical Mastectomy

83. 83

84. 84
Breast Conserving Surgery
-Lumpectomy
-Axillary Dissection
-Radiation Therapy

85. 85

86. 86

87. 87
Breast Reconstruction

88. 88

89. 89

90. 90

91. 91

92. 92
Chemotherapy

93. 93
CHEMOTHERAPY
-a systemic treatment
-4-6 cycles
-given every 21/28 days
-done as outpatient basis

94. 94
Radiation Therapy
Linear Accelerator

95. 95
Recurrence

96. TREATMENTS
• CURATIVE
• PALLIATIVE
96

97. 97
Disseminated Breast Cancer

98. 98

99. Breast Cancer
99
Early detection is the best.
Awareness of the signs and symptoms is very
important.
Go to your doctor when you have any problem with
your breast.

100. 100
roel_tolentino@yahoo.com
09328462203
8788-1412