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Cancer Care > Breast > Flashcards

Breast Flashcards

1
Q

What is the actual name for Herceptin?

A

Trastuzumab

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2
Q

What is the lifetime incidence of breast cancer?

A

1 in 8

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3
Q

What percentage of breast cancer is related to hereditary predisposition?

A

10

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4
Q

What hereditary predispositions to breast cancer exist?

A

BRCA 1 and 2

Li Fraumeni Syndrome

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5
Q

What is the most common type of breast Ca?

A

Invasive ductal carcinoma

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6
Q

Where does breast Ca commonly met to?

A 
Bone
Lung
Pleura
Adrenal 
Brain
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7
Q

What are the risk factors for breast Ca?

A 
Female 
Increasing age
Early menarche
Late menopause
Late 1st pregnancy 
Nulliparity 
HRT 
Family Hx
Hereditary - BRCA1/2 genes
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8
Q

What is the treatment for early breast Ca?

A

Wide local excision

Sentinel LN biopsy

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9
Q

What factors increase the risk of breast Ca recurrence?

A

Tumour >1cm
Presence of disease in axillary LNs
ER negative

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10
Q

How do aromatase inhibitors work?

A

Inhibit aromatase which inhibits peripheral oestrogen production in adipose tissue. This is the main source of oestrogen in post-menopausal women therefore there is significantly less oestrogen to drive tumour growth.

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11
Q

What forms the apex of the axilla?

A

Lateral border of first rib
Superior border of scapula
Posterior border or clavicle

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12
Q

What forms the lateral and medial borders of the axilla?

A

Lateral - intertubecular groove of humerus

Medial - serratus anterior and thoracic wall

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13
Q

What forms the anterior and posterior borders of the axilla?

A

Anterior - pec Major, pec minor and subclavius muscle

Posterior - subscapularis, teres major and latissimus dorsi

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14
Q

List some drugs that can cause gynaecomastia

A 
Anti androgens eg. Finasteride
Spironolactone
Anti-retrovirals
Oestrogen 
Cimetidine
Ketoconazole 
Amlodipine and verapamil 
PPIs
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15
Q

Which cancers are most likely to met to the breast?

A 
Lymphoma/leukaemia
Melanoma
Sarcoma
Prostate
Lung
Gastric 
Ovarian
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16
Q

How does COCP affect the risk of ovarian cancer?

A

Decreases the risk

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17
Q

How does HRT affect the risk of ovarian cancer?

A

Small increase in risk

18
Q

How does null/low parity affect the risk of ovarian cancer?

A

Increased risk

19
Q

How does COCP affect the risk of breast cancer?

20
Q

How does HRT affect the risk of breast cancer?

21
Q

How does null or low parity affect the risk of breast Ca?

22
Q

How does COCP affect the risk of endometrial cancer?

23
Q

How does HRT affect the risk of endometrial cancer?

A

Increased if HRT is oestrogen only

24
Q

How does null or low parity affect the risk of endometrial cancer?

25
Q

Which imaging modality is best for lobular carcinoma?

26
Q

Where is the oestrogen receptor located?

27
Q

Where is the HER2 receptor located?

A

Cell surface

28
Q

What is letrozole?

A

Selective aromatase inhibitor to decrease oestrogen production in peripheral tissue
Can only use in post-menopausal women as this is the main oestrogen supply

29
Q

What percentage of breast cancer is triple negative?

30
Q

What are the symptoms of inflammatory breast cancer?

A

Redness, swelling, pain
Pitted skin
Nipple discharge
Hot breast

31
Q

What is Paget’s disease of the breast?

A

Red, scaly rash like eczema on the skin of nipple

DCIS or invasive carcinoma

32
Q

What are the 2 views used on a mammogram?

A

Cranio-caudal

Mediolateral oblique

33
Q

30-50% of cancers appear as what on the mammogram?

A

Microcalcifications

34
Q

What is denosumab?

A

Human monoclonal antibody used for treatment of osteoporosis, mets to bone and bone tumours
Given by SC injection

35
Q

How does denosumab work?

A

Monoclonal antibody that targets RANKL protein needed for the new osteoclasts to be made and function

36
Q

What are the side effects of denosumab?

A

Muscle spasms and cramps
Bone and muscle pain
Osteonecrosis of the jaw

37
Q

What is pablociclib?

A

Targeted biological therapy that is taken alongside endocrine therapy in breast cancer
Offered to patients with ER+ and HER- locally advanced or secondary breast cancer

38
Q

What is duct ectasia?

A

Benign breast condition caused by normal shortening and widening of the ducts behind the nipple. Sometimes a fluid is produced

39
Q

What tumour markers do we look for in breast Ca?

A

CA 153

BRCA 1/2

40
Q

What are the breast red flags?

A 
Breast lump +/- pain
Nipple discharge
Nipple retraction
Breast skin changes
Axilla lump
41
Q

Describe T staging of breast

A

Is in situ

1: <2cm
2: 2-5cm
3: >5cm
4: through the chest wall or skin

Cancer Care (7 decks)

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