Breast Flashcards
What are the symptoms of bone metastases? (4)
- Back pain
- Hypercalcaemia
• constipation
• Abdominal pain
• disorientation
** Breast metastases**
(4) in order, list most common breast metastases.
1) Lungs
2) Bone
3) Liver
4) Brain
What does carcinoma in- situ mean?
Pre- invasive cancer that has not breached the epithelial BM
DCIS
Is the most common type of non invasive breast cancer. (T/F)
True
DCIS
Definition.
DCIS is the proliferation of malignant epithelial cells within the mammary ductal system.
- No invasion into surrounding stroma
DCIS
Progress of DCIS from normal cells. (3)
Ductal hyperplasia —> atypical ductal hyperplasia (ADH) —> DCIS
DCIS
What is the risk of DCIS becoming malignant?
High risk for malignancy in next 10 years
DCIS
What is the score used to prognosticate DCIS?
What are the parameters? (4)
Van Nuys prognostic Index
Size of lesion
Margin width
HPE classification (LG/HG)
Age
DCIS
Mainstay management of DCIS?
What is breast conserving therapy (BCS)?
What endocrine therapy recommended for women who didn’t do bilateral mastectomy?
Surgery: Breast conserving therapy OR mastectomy
Local excision of tumour w/o complete removal of breast +/- neoadjuvant chemotherapy +/- radiotherapy
Tamoxifen for those who have not menopause; aromatase inhibitor for those who have menopause
DCIS
What is Sentinel lymph node?
The sentinel Lymph node is the first LN that or group of nodes that drain lymph from the primary tumour
(axillary LN)
DCIS
Why is SLNB not done (surgeon dependent) in DCIS? (3)
It is recommended to be done in patients with total mastectomy or wide local excision.
It is not recommended in BCS as DCIS is theoretically confined and metastases is unlikely to occur.
The risk of developing lymphedema from SLNB is higher than the risk of malignant transformation of DCIS
DCIS
Is positive for E-cadherin. (Yes/No)
Yes
LCIS
Is this pre-malignant? (yes/no)
Does it distort lobular architecture? (yes/no)
LC and LCIS are commonly multifocal and/or bilateral? (yes/no)
No, unlike DCIS, LCIS is not pre-malignant.
No, unlike DCIS, this does not distort lobular architecture.
Yes
LCIS
treatment (3)
1) Lifelong close surveillance
2) Bilateral mastectomies
3) Prophylaxis with tamoxifen
Ductal carcinoma
Age seen in?
Most common variant for invasive breast cancer (T/F)
- Seen in Females >50
- True
Screening
Clinical breast examination (CBE) is advocated to start from what age?
From 35 years of age onwards