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Finals > Breast > Flashcards

Breast Flashcards

1
Q

What are the risk factors for breast cancer?

A
  • female
  • increased oestrogen exposure (earlier onset period, late menopause)
  • denser breast tissue
  • obesity
  • smoking
  • family history
  • HRT
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2
Q

Chromosome BRCA1

A

17

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3
Q

Chromosome BRCA 2

A

13

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4
Q

What are the types of breast cancer?

A
  • ductal carcinoma in situ
  • lobular carcinoma in situ
  • invasive ductal carcinoma
  • invasive lobular carcinoma
  • inflammatory breast cancer
  • Paget’s disease
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5
Q

What is ductal carcinoma in situ?

A
  • breast ducts
  • localised to a single area
  • potenital to spread locally or become invasive
  • good prognosis if fully excised and adjuvant used
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6
Q

What is lobular carcinoma in situ?

A
  • pre-cancerous
  • typically in pre menopausal women
  • usually asymptomatic
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7
Q

What is the management of lobular carcinoma in situ?

A
  • close monitoring
  • 6 monthly exam
  • yearly mammogram
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8
Q

What is inflammatory breast cancer?

A
  • presents similarly to breast abscess
  • wont respond to antibiotics
  • swollen, warm, tender breast with pitting skin
  • worse prognosis
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9
Q

What is paget’s diesase?

A
  • looks like eczema of the nipple
  • may represent DCIS or invasive breast cancer
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10
Q

What is the breast cancer screening programme?

A
  • mammogram every 3 years for women aged 50-70
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11
Q

What are the negatives of the breast screening programme?

A
  • anxiety/stress
  • exposure to radiation
  • false reassurance if cancer is missed
  • unnecessary tests/treatments where findings otherwise wouldnt have caused pain
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12
Q

Who are the high risk patients in regards to breast cancer

A
  • 1st degree relatives with breast cancer <40/male/bilateral and<50 first cancer
  • 2x first degree relatives with breast cancer
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13
Q

What is done with regards to those with high risk of breast cancer?

A
  • genetic testing and pre test counselling
  • annual mammogram
  • chemoprevention: tamoxifen if pre menopausal, anastrazole if post
  • risk reducing bilateral mastectomy or oophorectomy
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14
Q

What is the presentation of breast cancer?

A
  • hard/irregular/painless or fixed lump
  • lump tethered to skin/chest wall
  • nipple retraction
  • skin dimpling or oedema (peau d’orange)
  • lymphadenopathy
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15
Q

Breast cancer referral

A
  • 2 week wait in those with a lump and over aged 30, or unilateral nipple changes in patients 50+
  • consider in patients 30+ with an unexplained lump in the axilla, or skin changes suggestive of cancer
  • non-urgent referral for a breast lump in <30
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16
Q

Triple assessment

A
  1. clinical assessment
  2. imaging, USS if <30, mammogram if >30
  3. Biopsy: fine needle aspiration or core biopsy
17
Q

What are the breast cancer receptors?

A
  • Oestrogen receptors (ER)
  • Progesterone receptors (PR)
  • Human epidermal growth factor (HER2)
18
Q

Drugs targeting oestrogen receptors

A

Tamoxifen if premenopause, aromatase inhibitors if post menopausal

19
Q

Drugs targeting human epidermal growth factor receptors

A

Trastuzumab (herceptin), pertuzumab

20
Q

Where are the most common sites for breast cancer metastasis?

A
  • lung
  • liver
  • bones
    -brain
21
Q

What is the management of breast cancer

A
  • surgery: breast conserving (wide local excision) pr mastectomy (with or without reconstruction)
  • axillary clearance (increased risk of lymphoedema)
  • radiotherapy and chemotherapy
22
Q

What type of drug is tamoxifen?

A

Selective oestrogen receptor modulator

23
Q

What are the side effects of tamoxifen?

A
  • Hot flushes
  • Period abnormalities: vaginal bleeding, amenorrhoea
  • Increased risk of venous thromboembolism
  • endometrial cancer
24
Q

What are the side effects of anastrozole?

A
  • osteoporosis
  • hot flushes
  • arthralgia
  • myalgia
25
Q

Presentation of fibroadenoma

A
  • firm lump
  • mobile
  • non tender
26
Q

Presentation of breast cyst

A
  • perimenopausal women most likely
  • soft and fluctuant lump
27
Q

Breast cyst mammogram

A

Halo

28
Q

Presentation duct ectasia

A

Cheese like discharge

29
Q

Presentation of duct papilloma

A
  • nipple discharge, may be blood stained
30
Q

Presentation of fibroadenosis

A
  • Lump breast
  • painful
  • worsening of symptoms just before menstruation
31
Q

Presentation of mastitis

A
  • painful, red, hot breast
  • fever, general malaise
32
Q

When should a fibroadenoma be removed?

A

If over 3cm or phyllodes

Finals (37 decks)

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