8: Breast CPC / MDT Flashcards
Apart from increased or decreased density, what are some common mammography findings in breast cancer?
Microcalcifications
Necrosis
In which type of breast cancer is necrosis commonly seen?
In-situ cancers
Necrosis may be found within which breast structures?
Ducts
suggesting a ductal carcinoma
What other area, apart from the breasts, should be examined and imaged in suspected breast cancer?
Axilla
What type of mammogram is used to help insert a biopsy needle for a breast biopsy?
Stereotactic mammogram
Which type of core biopsy is commonly used to get breast cancer cells?
Vacuum assisted core biopsy
What can you do to an biopsy sample to confirm you’ve got the right tissue?
X-ray it
looking for the features you saw on the mammogram
How do you determine the grade of a ductal carcinoma in situ?
Compare tumour cells to the normal breast cells around them
Poorly differentiated (i.e wildly different from parent cells) is a sign of high grade and a poor prognosis
Which imaging is used to aid breast surgery?
Mammography
stereotactic again, with a wire
Which imaging is used to determine if the whole extent of a breast tumour has been removed?
X-ray
Why isn’t a sentinel node biopsy required for in-situ breast cancers?
Hasn’t breached the basement membrane
So by extension cannot have breached the lymph nodes
How can the risk of recurrence be reduced post-breast surgery?
Adjuvant radiotherapy
Distortion is a feature of (low grade / high grade) cancers.
low grade
AND radial scars
Which type of image-guided biopsy is the most comfortable for a patient?
USS
What histological feature would you see on radial scars?
“Architectural distortion”
i.e everything’s dodgy because there’s sclerosis
What is meant by the
a) stage
b) grade
of a tumour?
a) Local invasion
b) Degree of differentiation
Which measure is used to estimate breast cancer prognosis?
Nottingham Prognostic Index
Any number below 3 is excellent
Is adjuvant hormonal therapy indicated for women with very low grade breast cancers?
No
If the prognosis is excellent then adjuvants are just extra side effects
What scan is used to rule out metastatic disease in high grade invasive breast cancers?
CT scan
head chest pelvis bones etc.
then MRI scan to monitor the progression of disease and response to treatment
Transtuzumab is often given alongside which treatment?
Chemotherapy
What are the treatment options for breast cancer?
Surgery (breast conserving or radical) +/- axilla
Radiotherapy +/- axilla
Chemotherapy
Hormonal therapy
Herceptin
