Lack of postmenopausal weight gain o Clinical Manifestation Small painless lump

Lack of postmenopausal weight gain o clinical

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Lack of postmenopausal weight gain o Clinical Manifestation : Small, painless lump in breast, palpable lymph nodes (axilla, dimpled skin, nipple), skin retention, nipple discharge, redden skin, ulcers, bone pain - Involve uterus, cervix, ovaries, vagina (rare), START in the ductal epithelium Fibrocystic Breast Disease: non- proliferative breast lesions, not associated w/ cancer, simple breast cysts, papillary apocrine changes, mild hyperplasia - Chronic cystic mastitis, mammary dysplasia - Simple cysts are the most common, occur in women in their 40, 50, 60’s, near skin surface (feel squishy), deeply embedded (hard feeling) o Caused by: hormonal changes, genetics, age, parity, nipple discharge, chronic inflammation and palpable firmness, Benign Breast Disease: Causes of Breast Cancer: each woman has different genetic profile ( genetic heterogenicity ) - Phenotypic Plasticity: distinctive phenotype called EMT (epithelial-to-mesenchymal transition) - Tu mo r
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Dormancy: microscopic and occult cancerous lesions that become latent or dormant in various stages of cancer 1. Non- proliferative breast lesions : breast cysts, papillary apocrine change, mild hyperplasia (enlarge organ/tissue caused by an increase in reproduction of cell, it is initial stage of cancer 2. Proliferative breast disease: w/o atypia: ductal hyperplasia, intraductal papilloma’s, sclerosing adenosis, radial scar, fibroadenoma… w/ atypia: ADH and ALH 3. Atypical (atypia) hyperplasia Hormonal Risk Factors : - Early first pregnancy - Removal of ovaries and pituitary gland - Increased risk of early menarche, late menopause and nulliparity - Relationship of fat, free estrogen levels, estrogen metabolism - Hormone dependent development and mammary gland structure - Antihormone therapy for treatment/prevention of breast cancer - HRT or MHT: hormone-replacement therapy and menopausal hormone therapy - Dysplasia : the healthy cells undergo an abnormal change Environmental Factors: - Radiation: mutagen, x-rays, CT scans, fluoroscopy, radiological procedures, MRI (secondary lung malignancy) - Diet: alcohol, overweight, weight gain after menopause, fats, Mediterranean diet, carbohydrates, iodine deficiency - Obesity: leptin and adiponectin, excess adipose tissue, cytokines, IGF, immune functions - Environmental Chemicals: synthetic chemicals, EDC’s plasticizer bisphenol o Xenoestrogens: mimic actions of estrogen, pesticide, fuels, plastics, detergents, drugs, PCB’s, DDT, tobacco smoke, dioxins, metals, parabens, food additives - Physical Activity: regular physical activity can reduce risk of breast cancer, sedentary lifestyle, increased insulin resistance, inflammation, decreased immune function Screening for Breast Cancer: Harms of Screening: 1. Abnormal diagnosis: false positives causing anxiety and morbidity 2. Overdiagnosis: o DCIS: noninvasive, confined to duct, increased risk for diagnosis of breast cancer - Screen early for breast cancer (annually) o Depends on women’s age, breast density, time interval of screening exams Chapter 34: Alterations of the Male System Table 34-1, pg. 856-857
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Delayed Puberty:
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