Evaluation Cosmetic Outcome In Stage I And II Breast Carcinoma After Conservative Treatment

Abstract

Bladder cancer is the 9th most common cancer diagnosis worldwide, with more than 330,000 new cases each year and more than 130,000 deaths per year; the estimated male-to-female ratio for bladder cancer is 3.8: 1. Women are more likely to be diagnosed with primary muscle-invasive disease than men. Approximately one-third of patients diagnosed with muscle-invasive bladder cancer have undetected metastasis at the time of treatment of the primary tumor. The incidence of muscle-invasive disease has not changed for 5 years. Active and passive tobacco smoking continues to be the main risk factor, while exposure-related incidence is decreasing. The increased risk of bladder cancer of patients submitted to external beam radiation therapy, brachytherapy or a combination of external beam radiation therapy, brachytherapy must be taken into account during patient follow-up. As bladder cancer requires time to develop, patients treated with radiation at a young age are at the greatest risk and should be followed up closely. The predominant histologic findings associated with invasive carcinomas are transitional cell carcinomas. The incidence of squamous cell carcinoma of the bladder varies. The highest incidence has been seen in areas where schistosomiasis is endemic, notably Sudan and Egypt Patients with muscle-invasive disease tend to progress locally, with increasing tumor size and increasing depth of invasion leading to the involvement of extravesical structures and to metastatic disease, initially to the regional lymph nodes and subsequently to distant sites. A number of important risk factors for a progression to muscle-invasive disease have been identified. These factors include tumor grade, tumor size, the presence of solitary versus multiple lesions, history of prior recurrence(s), bladder neck involvement, and the presence of genetic risk factors. Tumor grade is clinically more significant for noninvasive tumors because nearly all of the invasive neoplasms are high grade at diagnosis. The pathological report should specify the grade, the depth of tumour invasion and whether the lamina propria and muscle are present in the specimen. The pathogenic pathway for muscle invasive URCa primarily involves alterations in tumor suppressor genes p53, p16 and Ritnoblastoma. This pathogenic pathways as well as angiogenesis pathway of the tumor micro environment offer