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PATHOPHYSIOLOGY of BREAST CANCER Predisposing factors: - family history of BR CA - age: 74 - gender: female Alteration in estrogen and progesterone levels

Alters other hormones secreting growth hormones Multiplication of cells Alters mitosis Transformation and mutation of normal cells to cancer cells Neoplastic cells grow progressively Facilitate tumor growth and metastasis by altering cell biology and activating stronal cell in tumor microenvironment such as vascular endothelial cells, tumor- associated macrophages and fibroblasts Invasion: tumor cells invade host stroma using enzymes, then enter blood streams or lymphatics Early detection: patient felt nodule (round, movable) treatment: MRM, cobalt radiation, chemotherapy Recurrence of transformed cell Grows and multiply in epithelial tissue Lesion: poorly defined mass, irregular Tumor continue to grow Fibrosis development around cancer Cancer eventually replaces skin itself and overlying skin ulcerates Seeding of cancer cell and lymph systems Spread of cells to distant sites (bone metastasis) Acute pain related to the disease process oxycodone Precipitating factors:

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