Breast

Question 1

Where is breast cancer most/least common

Answer 1

Most common in Western Europe, least common in Japan and Africa

Question 2

What type of cancer is breast cancer most likely to be?

Answer 2

Ductal adenocarcinoma (80%)
(20% lobular, mucinous tubular or medullary carcinoma)

Question 3

peau d’orange

Answer 3

Lymphoedema of the skin (looks like orange peel puckering) - suggests local lymph node involvement or locally advanced cancer

Question 4

Systemic features of breast cancer

Answer 4

• weight loss
• anorexia
• bone pain
• jaundice
• malignant pleural effusion
• pericardial effusion
• anaemia

Question 5

How should you investigate any breast lump or suspected breast carcinoma?

Answer 5

Triple assessment:

• clinical exam
• imaging (usually mammography, ultrasound or both)
• needle biopsy

Question 6

What other women should you screen as a precaution?

Answer 6

Younger women with dense breast tissue - these patients tend to have a strong family history

Question 7

How do you perform tissue diagnosis?

Answer 7

Core biopsy or fine needle aspiration cytology (FNAC)

-core biopsy also finds oestrogen receptor status, differentiates between invasive carcinomas and in situ carcinomas)