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You can change your ad preferences anytime. Upcoming SlideShare. Like this presentation? Why not share! Embed Size px. Start on. Show related SlideShares at end. WordPress Shortcode. Full Name Comment goes here. Are you sure you want to Yes No. An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.
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Generally, an eBook can be downloaded in five minutes or less Browse by Genre Available eBooks An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook. Show More.
Patricia Ramirez. No Downloads. Views Total views. Actions Shares. Embeds 0 No embeds. No notes for slide. Morales-Borges, M. RHMB 3. RHMB 4. Morales-Borges 8. Es el responsible de uno de cuatro muertes. Tasa por , Accessed March 19, Adapted from American Cancer Society and Hulka et al. Hartmann, L. However, i t is important to remember the clinical signs of breast cancer that would invalidate surgical attempts at cure.
In these instances, initial referral to a clinical oncologist would be more relevant. The staging systems currently in use are based on the clinical size and extent of invasion of the primary tumour T , the clinical absence or presence of palpable axillary lymph nodes and evidence of their local invasion N , together with the clinical and imaging evidence of distant metastases M.
Conocimiento de Receptores Hormonales Dashed line arrows indicate putative pathways. Oestrogens cause activation of various protein kinases, such as mitogen-activated protein kinases MAPK , and increase levels of second messengers, such as cAMP. Growth factor reduction of progesterone receptor PR via direct inhibition of PR gene transcription and induction of membrane-initiated oestrogen receptor ER signalling.
Reproduced with permission from Cui et al. Binding of epidermal growth factor EGF to the human epidermal growth factor receptor EGFR activates a cellular pathway, with induction of phosphorylation by intracellular kinases, leading to nuclear signals that increase cell proliferation.
Based on Lo et al. A tumour's hormone receptor status can be determined by immunohistochemistry. This photomicrograph demonstrates strong positive nuclear staining brown or black for oestrogen receptors in an infiltrating ductal carcinoma. Atlas of Cancer. Data from Colditz et al. Endocrine responsiveness is an important prognostic marker in breast cancer. ER, oestrogen receptor. Reproduced with permission from Hess et al.
Many hormones influence breast development and function, including oestrogens, progesterone, androgens, prolactin, and luteinising hormone-releasing hormone LHRH.
Oestradiol and, to a lesser degree, other steroid hormones e. Germline mutations in relevant tumour-suppressor genes accelerate the transformation to the malignant phenotype. Reproduced with permission from Henderson et al. A variety of reconstructive techniques are available today aimed at minimising the mutilation effect of mastectomy without compromising the oncological clearance Ahmed et al, A A schematic representation of the post-operative appearance after transverse rectus abdominis myocutaneous TRAM flap reconstruction.
Reproduced with permission from Dietz J et al. A A schematic representation of latissimus dorsi LD flap breast reconstruction. B A year-old patient after modified radical mastectomy with immediate reconstruction using the LD flap and submuscular saline implant. Data from Gazet et al. Careful attention to histopathology and quality assurance of treatment delivery is essential to ensure APBI is applied appropriately.
To this end, both the American Brachytherapy Society Arthur et al. The EBCTCG confirmed that polychemotherapy produced substantial and highly significant proportional reductions in relation to the risk of relapse and death from breast cancer. The effects of treatment were described as either proportional or absolute benefits.
For women under 50 years at randomisation, the absolute reduction in risk of relapse was The reduction was also significant for mortality absolute improvements in year survival of 5. CMF, cyclophosphamide, methotrexate and 5-fluorouracil. Data from Nabholtz et al. Data from Henderson et al. Following the success of trastuzumab in metastatic breast cancer, four large international multicentre trials were designed to test the efficacy of trastuzumab as adjuvant treatment either with or following chemotherapy.
AC, doxorubicin, cyclophosphamide; LN, lymph node. Data from Romond et al. Adapted from Piccart et al. There are international consensus guidelines based on clinicopathological features and outcomes, which are regularly updated to help inform local guidelines and individual clinicians.
The St Gallen guidelines have defined low-, intermediate- and high-risk categories. The St Gallen guidelines recommend adjuvant treatment according to risk and endocrine responsiveness. ET, endocrine therapy; CT, chemotherapy. Gracias …. You just clipped your first slide! Clipping is a handy way to collect important slides you want to go back to later. Now customize the name of a clipboard to store your clips. Visibility Others can see my Clipboard. Cancel Save.
Benign Breast Problems and Conditions
Categoría:Enfermedades de la mama