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BREAST LUMP

BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

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Page 1: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

Page 2: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

Abdul.Kader WEISS M.DCHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE

D.E.S , A.F.S ,A.F.S.A , DU / FRANCE

Reference Surgery at a Glance 2ed

Anatomy at a GlanceSchwartz's Principles of Surgery, Ninth Edition

Page 3: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DEFINITION

Page 4: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DEFINITION

ANY PALPABLE MASS IN THE BREAST

Page 5: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

ENLARGEMENT OF THE WHOLE BREAST CANOCCUR EITHER UNI- OR BILATERALLY

Page 6: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BUT

Page 7: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THIS IS NOT STRICTLY A BREAST LUMP

Page 8: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

ANATOMY

Page 9: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SPECIALIZED SKIN GLANDS

Page 10: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SPECIALIZED SKIN GLANDSCOMPRISING

Page 11: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SPECIALIZED SKIN GLANDSCOMPRISING

FAT

Page 12: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SPECIALIZED SKIN GLANDSCOMPRISING

FATGLANDULAR

Page 13: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SPECIALIZED SKIN GLANDSCOMPRISING

FATGLANDULAR

AND CONNECTIVE TISSUE

Page 14: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 15: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 16: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BLOOD SUPPLY

Page 17: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 18: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

VENOUS DRAINAGE

Page 19: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

VENOUS DRAINAGECORRESPONDS TO THE ARTERIAL SUPPLY

Page 20: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LYMPHATIC DRAINAGE

Page 21: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

Page 22: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

A - THE AXILLARY VEIN GROUP (LATERAL), 4-6 L.NS

Page 23: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

A - THE AXILLARY VEIN GROUP (LATERAL), 4-6 L.NS B - THE EXTERNAL MAMMARY GROUP (ANTERIOR GROUP), 5-6 L.Ns

Page 24: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

A - THE AXILLARY VEIN GROUP (LATERAL), 4-6 L.NS B - THE EXTERNAL MAMMARY GROUP (ANTERIOR GROUP), 5-6 L.NsC - THE SCAPULAR GROUP (POSTERIOR OR SUBSCAPULAR), 5-7 L.Ns

Page 25: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

A - THE AXILLARY VEIN GROUP (LATERAL), 4-6 L.NS B - THE EXTERNAL MAMMARY GROUP (ANTERIOR GROUP), 5-6 L.NsC - THE SCAPULAR GROUP (POSTERIOR OR SUBSCAPULAR), 5-7 L.NsD - THE CENTRAL GROUP, 3-4 L.Ns , EMBEDDED IN THE FAT OF THE

AXILLA

Page 26: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

A - THE AXILLARY VEIN GROUP (LATERAL), 4-6 L.NS B - THE EXTERNAL MAMMARY GROUP (ANTERIOR GROUP), 5-6 L.NsC - THE SCAPULAR GROUP (POSTERIOR OR SUBSCAPULAR), 5-7 L.NsD - THE CENTRAL GROUP, 3-4 L.Ns , EMBEDDED IN THE FAT OF THE

AXILLA E - THE SUBCLAVICULAR GROUP (APICAL ), 6-12 L.Ns

Page 27: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE SIX AXILLARY LYMPH NODE GROUPS RECOGNIZED BY SURGEONS

A - THE AXILLARY VEIN GROUP (LATERAL), 4-6 L.NS B - THE EXTERNAL MAMMARY GROUP (ANTERIOR GROUP), 5-6 L.NsC - THE SCAPULAR GROUP (POSTERIOR OR SUBSCAPULAR), 5-7 L.NsD - THE CENTRAL GROUP, 3-4 L.Ns , EMBEDDED IN THE FAT OF THE

AXILLA E - THE SUBCLAVICULAR GROUP (APICAL ), 6-12 L.Ns

F - THE INTERPECTORAL GROUP (ROTTER'S NODES), 1-4 L.Ns

Page 28: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 29: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LYMPHATIC PATHWAYS OF THE BREAST

Page 30: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LYMPHATIC PATHWAYS OF THE BREAST

Page 31: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LYMPHATIC PATHWAYS OF THE BREAST

LEFT BREAST

Page 32: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LYMPHATIC PATHWAYS OF THE BREAST

LEFT BREAST

ARROWS INDICATE THE DIRECTION OF LYMPH FLOW

Page 33: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE LYMPH NODE GROUPS LEVELS ACCORDING TO THEIR ANATOMIC RELATIONSHIP TO THE PECTORALIS MINOR MUSCLE

Page 34: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE LYMPH NODE GROUPS LEVELS ACCORDING TO THEIR ANATOMIC RELATIONSHIP TO THE PECTORALIS MINOR MUSCLE

Page 35: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE LYMPH NODE GROUPS LEVELS ACCORDING TO THEIR ANATOMIC RELATIONSHIP TO THE PECTORALIS MINOR MUSCLE

Lymph nodes located lateral to or below the lower border of the pectoralis minor

muscle are referred to as LEVEL I LYMPH NODES

which include the axillary vein, external mammary, and scapular groups.

Page 36: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE LYMPH NODE GROUPS LEVELS ACCORDING TO THEIR ANATOMIC RELATIONSHIP TO THE PECTORALIS MINOR MUSCLE

Lymph nodes located superficial or deep to the pectoralis minor muscle are

referred to as LEVEL II LYMPH NODES

which include the central and interpectoral groups.

Page 37: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE LYMPH NODE GROUPS LEVELS ACCORDING TO THEIR ANATOMIC RELATIONSHIP TO THE PECTORALIS MINOR MUSCLE

Lymph nodes located medial to or above the upper border of the pectoralis minor

muscle are referred to as LEVEL III LYMPH NODES

which consist of the subclavicular group

Page 38: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THE LYMPH NODE GROUPS LEVELS ACCORDING TO THEIR ANATOMIC RELATIONSHIP TO THE PECTORALIS MINOR MUSCLE

Page 39: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

TOPOGRAPHY

Page 40: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

TOPOGRAPHY

Page 41: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

Page 42: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

KEY POINTS

Page 43: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

KEY POINTS• The commonest breast lumps occurring under the age of 35

years are fibroadenomas and fibrocystic disease.

Page 44: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

KEY POINTS• The commonest breast lumps occurring under the age of 35

years are fibroadenomas and fibrocystic disease.• The commonest breast lumps occurring over the age of 50

years are carcinomas and cysts.

Page 45: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

KEY POINTS• The commonest breast lumps occurring under the age of 35

years are fibroadenomas and fibrocystic disease.• The commonest breast lumps occurring over the age of 50

years are carcinomas and cysts. • Pain is more characteristic of infection/inflammation than

tumours.

Page 46: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

KEY POINTS• The commonest breast lumps occurring under the age of 35

years are fibroadenomas and fibrocystic disease.• The commonest breast lumps occurring over the age of 50

years are carcinomas and cysts. • Pain is more characteristic of infection/inflammation than

tumours.• Skin/chest wall tethering is more characteristic of tumours

than benign disease.

Page 47: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST LUMP

KEY POINTS• The commonest breast lumps occurring under the age of 35

years are fibroadenomas and fibrocystic disease.• The commonest breast lumps occurring over the age of 50

years are carcinomas and cysts. • Pain is more characteristic of infection/inflammation than

tumours.• Skin/chest wall tethering is more characteristic of tumours

than benign disease.• Multiple lesions are usually benign (cysts or fibrocystic

disease).

Page 48: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 49: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 50: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 51: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 52: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 53: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 54: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 55: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 56: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 57: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 58: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 59: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 60: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 61: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 62: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 63: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 64: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 65: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a
Page 66: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DIFFERENTIAL DIAGNOSIS

Page 67: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DIFFERENTIAL DIAGNOSIS

Page 68: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DIFFERENTIAL DIAGNOSIS

WHOLE

Page 69: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DIFFERENTIAL DIAGNOSIS

WHOLE LOCALIZED

Page 70: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DIFFERENTIAL DIAGNOSIS

WHOLE LOCALIZED

BEHIND

Page 71: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

Page 72: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCY

Page 73: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCYLACTATION

Page 74: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCYLACTATIONIDIOPATHIC HYPERTROPHY

Page 75: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCYLACTATIONIDIOPATHIC HYPERTROPHY

DRUG INDUCED

Page 76: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCYLACTATIONIDIOPATHIC HYPERTROPHY

DRUG INDUCED (E.G. STILBOESTROL, CIMETIDINE)

Page 77: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCYLACTATIONIDIOPATHIC HYPERTROPHY

DRUG INDUCED (E.G. STILBOESTROL, CIMETIDINE)

ENLARGEMENT IN THE N.B

Page 78: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLING OF THE WHOLE BREASTBILATERAL UNILATERAL

PREGNANCYLACTATIONIDIOPATHIC HYPERTROPHY

DRUG INDUCED (E.G. STILBOESTROL, CIMETIDINE)

ENLARGEMENT IN THE N.B

PUBERTY

Page 79: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS

Page 80: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREAST

Page 81: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset

Page 82: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

Page 83: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS

Page 84: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.

Page 85: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

Page 86: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS

Page 87: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

Page 88: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.

Page 89: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.

Page 90: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.• LIPOMA: well defined, soft, non-tender, fairly mobile.

Page 91: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.• LIPOMA: well defined, soft, non-tender, fairly mobile.• CYSTOSARCOMA PHYLLOIDES: wide surgical excision (10% are malignant).

Page 92: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.• LIPOMA: well defined, soft, non-tender, fairly mobile.• CYSTOSARCOMA PHYLLOIDES: wide surgical excision (10% are malignant).

MALIGNANT INCLUDE:

Page 93: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.• LIPOMA: well defined, soft, non-tender, fairly mobile.• CYSTOSARCOMA PHYLLOIDES: wide surgical excision (10% are malignant).

MALIGNANT INCLUDE:• CARCINOMA

Page 94: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.• LIPOMA: well defined, soft, non-tender, fairly mobile.• CYSTOSARCOMA PHYLLOIDES: wide surgical excision (10% are malignant).

MALIGNANT INCLUDE:• CARCINOMA

EARLY : ill defined, hard, irregular, skin tethering

Page 95: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

LOCALIZED SWELLINGS IN THE BREASTMASTITIS/BREAST ABSCESS• DURING LACTATION:RED, hot, tender lump, systemic upset• TUBERCULOUS ABSCESS: chronic, ‘cold’, recurrent, discharging sinus.

CYSTS• GALACTOCELE: commoner postpartum, tender but not inflamed, milky contents.• FIBROCYSTIC DISEASE: irregular, ill defined, often tender.

SOLID LUMPS BENIGN INCLUDE:

• FIBROADENOMA: discrete, firm, well defined, regular, highly mobile.• FAT NECROSIS: irregular, ill defined, hard, ?skin tethering.• LIPOMA: well defined, soft, non-tender, fairly mobile.• CYSTOSARCOMA PHYLLOIDES: wide surgical excision (10% are malignant).

MALIGNANT INCLUDE:• CARCINOMA

EARLY : ill defined, hard, irregular, skin tethering LATE : spreading fixity, ulceration, fungation, ‘peau d’orange’.

Page 96: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLINGS BEHIND THE BREAST

Page 97: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLINGS BEHIND THE BREAST

RIB DEFORMITIES

Page 98: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLINGS BEHIND THE BREAST

RIB DEFORMITIES CHONDROMA

Page 99: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

SWELLINGS BEHIND THE BREAST

RIB DEFORMITIES CHONDROMA

COSTOCHONDRITIS (TIETZE’S DISEASE)

Page 100: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS

Page 101: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Page 102: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

Page 103: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

Page 104: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

ULTRASOUNDFibroadenoma, cysts, tumours (best for young women/ dense breasts)

Page 105: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

ULTRASOUNDFibroadenoma, cysts, tumours (best for young women/ dense breasts)

MAMMOGRAPHY

Page 106: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

ULTRASOUNDFibroadenoma, cysts, tumours (best for young women/ dense breasts)

MAMMOGRAPHYTumours, cysts, fibrocystic disease, fat necrosis.

Page 107: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

ULTRASOUNDFibroadenoma, cysts, tumours (best for young women/ dense breasts)

MAMMOGRAPHYTumours, cysts, fibrocystic disease, fat necrosis.

BIOPSY (‘TRUCUT’/OPEN SURGICAL)

Page 108: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

KEY INVESTIGATIONS FNAC

Tumours, fibroadenoma, fibrocystic disease, fat necrosis,mastitis

ULTRASOUNDFibroadenoma, cysts, tumours (best for young women/ dense breasts)

MAMMOGRAPHYTumours, cysts, fibrocystic disease, fat necrosis.

BIOPSY (‘TRUCUT’/OPEN SURGICAL)Usually provides definitive histology (may be radiologically guided if lump is small or impalpable-detected by mammography as part of breast screening

programme

Page 109: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

EXAMINATION OF THE BREAST

Page 110: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

EXAMINATION OF THE BREAST

Page 111: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

A. Inspection of the breast with arms at sides.

EXAMINATION OF THE BREAST

Page 112: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

A. Inspection of the breast with arms at sides.B. Inspection of the breast with arms raised.

EXAMINATION OF THE BREAST

Page 113: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

A. Inspection of the breast with arms at sides.B. Inspection of the breast with arms raised. C. Palpation of the breast with the patient supine.

EXAMINATION OF THE BREAST

Page 114: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

A. Inspection of the breast with arms at sides.B. Inspection of the breast with arms raised. C. Palpation of the breast with the patient supine.D. Palpation of the axilla.

EXAMINATION OF THE BREAST

Page 115: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DUCTOGRAM

Page 116: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

DUCTOGRAM

Page 117: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST CYSTECHOGRAPHY

Page 118: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

BREAST CYSTECHOGRAPHY

Page 119: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

MAMMOGRAPHY

Page 120: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

MAMMOGRAPHY

Page 121: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THANK YOU

Page 122: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THANK YOUAbdul.Kader WEISS M.D 2010

Page 123: BREAST LUMP. Abdul.Kader WEISS M.D CHIRURGIE GENERALE ET VISCERALE /CHIRURGIE COELIOSCOPIQUE D.E.S, A.F.S,A.F.S.A, DU / FRANCE Reference Surgery at a

THANK YOUAbdul.Kader WEISS M.D 2010