| Breast cancer is one of the the most common | | | | bone scanning using radioactive isotopes, which |
| malignancies in women. In the early stages, | | | | are avidly taken up by the tumor metastases in |
| curative treatment may include surgery, | | | | bone. |
| radiotherapy, and chemotherapy. | | | | Lymphatic drainage of the breast is complex. |
| Breast cancer develops in the cells of acini, | | | | Lymph vessels pass to axillary, supraclavicular, |
| lactiferous ducts, and lobules of the breast. Tumor | | | | parasternal, and lymphatic lymph nodes as well as |
| growth and spread depends on the exact cellular | | | | the opposite breast. Subcutaneous lymphatic |
| site of origin of the cancer. These factors affect | | | | obstruction and tumor growth pull on connective |
| the response to surgery, chemotherapy, and | | | | tissue ligaments in the breast resulting in |
| radiotherapy. Breast tumors spread via the | | | | appearance of an orange peel texture(peau |
| lymphatics and veins, or by direct invasion. | | | | d'orange)on the surface of breast. Further |
| When a patient presents with a lump in the | | | | subcutaneous spread can induce a rare |
| breast, a diagnosis of breast cancer is confirmed | | | | manifestation of breast cancer that produces a |
| by a biopsy and histologic evaluation. Once | | | | hard. woody texture to the skin(cancer en |
| confirmed, the clinician must attempt to stage the | | | | cuirasse). |
| tumor. | | | | Amastectomy involves excision of the breast |
| Staging the tumor means defining: | | | | tissue to the pectoralis major muscle and fascia. |
| . size of the primary tumor; | | | | Within the axilla the breast tissue must be |
| . exact site of the primary tumor; | | | | removed from the medial axillary wall. Closely |
| . number and site of lymph node spread; | | | | applied to the medial axillary wall is the long |
| . organ to which the tumor may have spread. | | | | thoracic nerve. Damaged to this nerve can result |
| Computed tomography scanning of the body may | | | | in paralysis of serratus anterior muscle producing |
| be carried out to look for any spread to the | | | | a characteristic 'winged' scapula. |
| lungs, liver, or bone. Further imaging may include | | | | |