SURGERY of carcinoma of breast details 1.pptx

basic surgery ideas

1. SURGERY GENERAL SURGERY

2. 1. Breast Mass Approach Breast mass refers to any localized swelling, lump, or abnormal growth in the breast tissue. Importance: Prompt evaluation and management are essential to differentiate benign from malignant causes.

3. Clinical Presentation Symptoms: Palpable lump Pain or tenderness ( mastalgia ) Nipple discharge Skin changes: dimpling, erythema, peau d'orange Patient Demographics: Age group Family history

4. History Taking: Onset and duration Cyclic vs. non-cyclic symptoms Associated nipple discharge Menstrual history and hormonal use Physical Examination: Location, size, and mobility of the mass Axillary and supraclavicular lymph nodes Bilateral breast comparison

5. Imaging: Mammography: First-line for women >40 years Ultrasound: Preferred for women <40 years or dense breasts MRI: In specific cases like high-risk patients Tissue Sampling: Fine Needle Aspiration Cytology (FNAC) Core Needle Biopsy Excisional biopsy (if indicated)

6. Differential Diagnosis Benign Causes: Fibroadenoma Breast cyst Fibrocystic changes Lipoma Fat necrosis Malignant Causes: Ductal carcinoma in situ (DCIS) Invasive ductal or lobular carcinoma

7. Risk Stratification Red Flags for Malignancy: Fixed, hard mass Skin changes Nipple retraction or discharge (bloody/serous) Axillary lymphadenopathy

8. Management Approach Benign Lesions: Observation and follow-up Surgical excision if symptomatic or large Suspicious/Malignant Lesions: Refer to a specialist for further evaluation Multidisciplinary team approach (oncology, surgery, radiology)

9. Case Scenarios Case 1: A 25-year-old with a mobile, painless lump. Probable Diagnosis: Fibroadenoma Management: Ultrasound + FNAC Case 2: A 55-year-old with a fixed, irregular lump and bloody discharge. Probable Diagnosis: Malignancy Management: Mammogram + Core biopsy