Benign Breast Disease and Breast Cancer Flashcards
True or false: Breast cancer is the most common cause of female cancer in the US?
True
Breast cancer is the ____ most common cause of cancer related death in women?
second
True or false: Breast cancer is the main cause of death among women age 45 - 59
True
What is the most common breast tumor?
Fibroadenoma
At what age does ACOG recommend starting screening mammographies and at what frequency?
40 yrs, q 1 - 2 years
At what age does ACOG recommend ending screening mammographies?
75 yrs
What is the biggest risk factor in terms of relative risk for developing breast cancer?
Age
When do you start screening high risk patients
25 years with yearly mammogram and MRI
*BRCA and previous chest radiation
What does BIRADS 0 mean?
Need for additional imaging
What does BIRADS 1 mean?
negative, routine screening recommended
What does BIRADS 2 mean?
benign, routine screening recommended
What does BIRADS 3 mean?
probably benign, repeat mammogram in 6 months
What does BIRADS 4 mean?
Suspicious, get a biopsy
What does BIRADS 5 mean?
Highly suspicious, get a biopsy
What does BIRADS 6 mean?
Known proven biopsy, surgical excision
What are the most specific mammographic feature of breast cancer?
Spiculated mass, clustered microcalcifications
What is the first step in management in a patient < 30 yrs with a palpable mass?
Ultrasound
When should you biopsy a mass in a patient < 30 yrs following ultrasound?
If mass is solid, complex or cystic with symptoms
What is the next step in management if you do a FNA on a cystic mass in a patient < 30 and the fluid is bloody?
Core biopsy or excision
What is the first step in management in a patient > 30 yrs with a palpable mass?
Diagnostic mammogram
What is the first step in management of a patient < 30 yrs with spontaneous nipple discharge?
Ultrasound
What is the first step in management of a patient > 30 yrs with spontaneous nipple discharge?
Mammogram
If a patient has spontaneous nipple discharge from one duct or it is bloody what is the next step in management?
biopsy
Management of Lobular in situ?
close surveillance
Management of ductal in situ?
Lumpectomy
True or False: Lumpectomy + radiation therapy has equivalent survival rates to mastectomy
True
Definition of stage I breast cancer
Tumor < 2 cm, negative nodes
Definition of stage II breast cancer
Tumor > 2 cm but < 5 cm, positive Ipsilateral and mobile nodes
Definition of stage III breast cancer
Tumor > 5 cm in greatest dimension
Definition of stage IV breast cancer
Tumor of any size with direct extension to the chest wall and/or skin ulcerations with skin nodules
When should you do adjuvant chemotherapy in a breast cancer patient?
Premenopausal, young, ER/PR negative, positive lymph nodes, tumor size > 1 cm
When should you consider neoadjuvant chemotherapy
Large tumor size
What is the most common type of invasive breast cancer?
invasive ductal carcinoma
True or false: Ductal carcinoma occurs in younger patiensts
True
What are the treatment options for ER PR positive breast cancers?
Tamoxifen, Aromatase inhibitors or ovarian ablation/suppression
What are the treatment options for Her 2 receptor positive?
Herceptin/Trastuzamab
What is the most common chemotherapy used to treat breastcancer?
Doxorubicin with Taxane
What is a main side effect of AIs?
bone and joint pain, increased risk osteoporosis
Ideal treatement regimen for SERMS and AIs?
5 years of SERMS then switch to AI
What are the two main risk factors for recurrence?
Number of positive lymphnodes and size of tumor
What is the most predictive factor for recurrence?
number of positive lymph nodes
What is the most common location for recurrence?
chest wall post mastectomy
What is the most common nodal location for recurrence?
Supraclavicular
What is the median time to recurrence?
2-3 years
