7.1.2 Breast Cancer Flashcards
How common is breast cancer?
Most common cancer
1/7 women
Male breast cancer makes up 1% of all cases (increased risk with Klinefelter’s and trans women, as treated with oestrogen for prostate cancer)
What is the most common type of breast cancer?
95% adenocarcinomas
Where on the breast does cancer most commonly affect?
Upper outer quadrant
What are the risk factors of breast cancer?
BREAST
Breast feeding
Reproductive history, partity and age at first full term pregnancy
Exogenous oestrogens (HRT)
Age
Sex- female more likely
Time of menopause, later= more risk
What genes are involved in hereditary breast cancers?
10% of all breast cancers
BRCA1/2
p53 (Li-Fraumeni syndrome)
Tumour supressor genes- their proteins repair damaged DNA
How is breast carcinoma classified?
In sutu and invasive
Ductal or lubular
What is in situ carcinoma?
Neoplastic population of cells limited to ducts and lobules by byasement membrane
Myoepithelial cells are preserved
Does not invade into vessels, therefore cannot metastasis or kill patient
Why is ductal carcinoma in situ a problem?
Non-obligate precursor of invasive carcinoma
Presents as mammographic calcifications but can present as a mass
Can spread through ducts and lobules and can be very extensive
What is shown on histology of ductal carcinomas in situ?
Central (comedo) necrosis with calcification
What is Paget’s disease?
Cancer cells extend to nipple skin without crossing basement membrane
Causes a unilateral red and crusting nipple
Eczematous or inflammatory nipple should be investigated and biopsied to exclude pagets
Outline the features of invase carcinoma
Neoplastic cells invade beyond basement membrane into stroma
Can invade into vessels so can spread to lymph nodes and other sites
Usually presents as a mass or mammographic abnormality
By the time it is palpable patients normally have axillary lymph node metastases
What is Peau d’orange?
Involvement of lymphatic drainage of the skin
What are the different types of invasive breast carcinomas?
Invasive ductal carcinoma
Invasive lobular carcinoma
Other types- tubular, mucinous
(these have good prognosis, found often in older women)
Card showing normal breast tissue vs invasive ductal carcinoma
Normal breast
Invasive ductal carcinoma NST
What is this showing?
Invasive lobular carcinoma