15. Breast Cancer Flashcards
What sort of cancer are most breast tumours?
Carcinomas (arising from ductile tissue)
Recall the structure of the epithelium in normal breast
2 layers - inner epithelium and myoepithelium (contractile)
Recall 2 types of carcinoma that can arise from an in situ carcinoma of the breast
Lobular Medullary
Which of the 2 types of breast carcinoma are better differentiated?
Lobular
What % of breast cancers are ER+?
80
What is the most common form of ER+ breast cancer?
Infiltrating ductal carcinoma
Recall 3 factors that influence lifetime oestrogen exposure
- Menarche 2. Timing of first pregnancy 3. Contraceptive pill/ HRT
Recall 4 important genes that are regulated by oestrogen
Progesterone receptor TGF-alpha c-Myc Cyclin D1
Recall the 3 general approaches to medical breast cancer treatment
- Ovarian ablation 2. Enzyme inhibition 3. Oestrogen inhibition
Recall the 3 options for ovarian ablation
- Surgical oophrectomy 2. Ovarian irradiation 3. LHRH agonist
Which of the options for ovarian ablation is most useful in pre-menopausal women?
LHRH agonist - no risk of fertility loss
How is LH suppressed by LHRH agonist treatment?
Overload of LH = down-regulation of receptors –> LH suppression
Recall the 2 approaches of oestrogen inhibition in breast cancer therapy
Aromatase inhibitors Antioestrogens
What are the 2 classes of aromatase inhibitor?
Suicide inhibitors Competitive inhibitors
Give an example of a suicide-inhibitor aromatase inhibitor
Exemestane
