青年教师技能大赛 PPT课件.pptx
乳乳 房房 疾疾 病病 忻 莹 乳腺甲状腺外科 杭州医学院附属浙江省人民医院 ONTENTSC1乳房解剖、生理、功能乳房解剖、生理、功能 234辅助检查辅助检查 5常见乳房疾病常见乳房疾病乳房、腋窝查体乳房、腋窝查体乳房与艺术乳房与艺术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,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,nipplelumpskin ulcerationaxillary lymph node enlargementdimpling signorange-peel signnipple discharge&retraction shape change Clinical manifestation hyperplasia of mammary glands periodic pain.tuberculosis rare,often not primary.benign lumpsfibroadenoma,phylloides,cyst,lipoma,etc.mastitistrauma,lactation,anatomy defect Differential Diagnosispbones of a woman,showing the deformations of metastatic breast cancer.p French surgeon Barthlmy Cabrol.p to remove the underlying chest muscles+breast.pWilliam Halsted,U.Spradical mastectomy:breast+pectoralis major/minor muscles+ALD A tumor through time 2200 BCDEEP CUT 1590 KNIFE SKILLS 1894 pRobert Egan,an X-ray examination to detect breast tumours.p1970s,mammography.psurgery combined with chemotherapy works better ptamoxifen approved in the United States as a treatment for advanced metastatic breast cancer.A tumor through timeDOUBLE STANDARD 1975 DRUG STOP 1977X-RAY VISION 1956 A tumor through timepThe US Nurses Health Study reveals that HRT increases the risk of breast cancerpPeople live as long after lumpectomy combined with radiation as they do after radical mastectomy.pBRCA1,BRCA 2.p“triple-receptor-negative”breast cancer pHerceptinGENE TIMESBUSTED FLUSH 1995 LESS IS MORE 2002 ndocummentary:PE,DDx,plannsurgical technique:suture,dressing changento take care of your patient:physical,psychologicalLet Your Patient Be Your Artwork010203Breast-conserving radical resection with omentum reconstructionDo You Agree It Is Art?Cosmetic outcome after surgeryProspects Prospects Targeted Intraoperative Radiotherapy Art and Art Images in Research competition organised by University College London,UKtailed treatments,more precise,less side