1、,乳 房 疾 病,忻 莹 乳腺甲状腺外科 杭州医学院附属浙江省人民医院,乳房、腋窝查体,乳房与艺术,Breast cancer and Art,，,Bathsheba Bathing by Rembrandt Harmensz van Rijn (1606-1669)沐浴的芭特叶巴，伦勃朗,La Notte by Michelangelo di Lodovico Buonarroti Simoni (1475-1564)夜，米开朗基罗,Breast Cancer and Art,La Fornarina by Raffaello Sanzio of Urbino (14831520) 弗马里娜
2、，拉斐尔,The Madonna Delivers Milan From the Plague by II Cerano (15731632) 麦当娜在瘟疫中诞下米兰，切拉诺,Anatomy,LN, lobe, lobule, duct, gland, nipple,lumpskin ulcerationaxillary lymph node enlargement,dimpling signorange-peel signnipple discharge & retraction shape change,Clinical manifestation,hyperplasia of mamma
3、ry glands,periodic pain.,tuberculosis,rare, often not primary.,benign lumps,fibroadenoma, phylloides, cyst, lipoma, etc.,mastitis,trauma, lactation, anatomy defect,Differential Diagnosis,bones of a woman, showing the deformations of metastatic breast cancer.,French surgeon Barthlmy Cabrol. to remove
4、 the underlying chest muscles+breast.,William Halsted , U.Sradical mastectomy:breast+ pectoralis major/minor muscles +ALD,A tumor through time,2200 BC,DEEP CUT 1590,KNIFE SKILLS 1894,Robert Egan , an X-ray examination to detect breast tumours. 1970s, mammography.,surgery combined with chemotherapy w
5、orks better,tamoxifen approved in the United States as a treatment for advanced metastatic breast cancer.,A tumor through time,DOUBLE STANDARD 1975,DRUG STOP 1977,X-RAY VISION 1956,A tumor through time,The US Nurses Health Study reveals that HRT increases the risk of breast cancer,People live as lon
6、g after lumpectomy combined with radiation as they do after radical mastectomy.,BRCA1,BRCA 2.“triple-receptor-negative” breast cancer Herceptin,GENE TIMES,BUSTED FLUSH 1995,LESS IS MORE 2002,docummentary：PE， DDx， plan,surgical technique: suture, dressing change,to take care of your patient: physical
7、, psychological,Let Your Patient Be Your Artwork,01,02,03,Breast-conserving radical resection with omentum reconstruction,Do You Agree It Is Art?,Cosmetic outcome after surgery,Prospects,Targeted Intraoperative Radiotherapy Art and Art Images in Research competition organised by University College London, UKtailed treatments, more precise, less side effects,,
