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402: OHP > Breast, bowel and lung cancer > Flashcards

Breast, bowel and lung cancer Flashcards

1
Q

Classifications of breast cancer

A

Ductal carcinoma in situ

Lobular carcinoma in situ

Invasive ductal carcinoma

Invasive lobular carcinoma

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2
Q

Genetic associations with breast cancer

A

BRCA1, BRCA2

HER2

TP53

PTEN

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3
Q

Risk factors of breast cancer

A

Family history

Hx of ovarian/ endometrial

Combined HRT

Smoking

Increased oestrogen exposure: obesity, early menarches, late menopause

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4
Q

First line investigations for breast cancer

A

Triple assessment

  • Mammogram
  • Fine need biopsy and histology
  • Lymph node biopsy
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5
Q

What receptors are screened for in breast cancer

A

Oestrogen receptor

Progesterone receptor

HER2

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6
Q

__________ tend to be detected on mammograms by forming microcalfications

A

ductal carcinoma

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7
Q

Examples of benign breast tumours

A

Fibroadenoma

Adenoma

Papilloma

Lipoma

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8
Q

Breast cancer screening starts from age _____ and occurs every _____ years until age ____

A

Age 50, every 3 years until age 70

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9
Q

Family history High risk factors for breast cancer

A

1st degree relative affected <40 or bilateral <50.

1st degree male affected

Two 1st degree relatives affected.

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10
Q

Patients with high risk family history for breast cancer are….

A

Offered annual mammograms

Given chemoprevention/ can have surgery

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11
Q

Chemoprevention for breast cancer

A

Tamoxifen (for premenopausal)

Anastrozole (post-menopausal)

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12
Q

2-week referral indications for breast cancer

A

Unexplained breast/ axillary lump in age >30

Unilateral nipple changes in age >50

Breast cancer skin changes

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13
Q

_________ index is used for staging breast cancer

A

Nottingham prognostic index

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14
Q

______ is the therapy used to target HER2 in breast cancer

A

Herceptin

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15
Q

_______ is the therapy used to target oestrogen-receptor positive breast cancer

A

Tamoxifen (pre-menopausal)

Anastrozole (post-menopausal)

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16
Q

______ is a labelling protein used for breast cancer that is associated with proliferation

A

Ki67

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17
Q

Breast cancer subtypes (immunohistochemistry)

A

Eostrogen receptor positive (Luminal)= 75%

  • Luminal A= PR also strongly positive. Low grade and proliferation.
  • Luminal B= high grade and proliferation

HER2 positive= 15%
- 50% also ER+

Triple negative
- ER, PR and HER2 negative.

18
Q

Examples of breast conserving surgery for breast cancer

A

Lumpectomy

Mammoplasty

Wide-local excision

19
Q

Short term risks of radiotherapy for breast cancer

A

Skin erythema

Rare: Skin necrosis, lymphoedema, pneumonitis, oesophagitis

20
Q

Long term risks of radiotherapy for breast cancer

A

Smaller breast

Telangiectasia

Rib fracture

Secondary malignancy

21
Q

Adjuvatn chemotherapy is used for ________ breast cancer

A

HER2 + and triple negative breast cancer

22
Q

Tamoxifen works by…

A

Anti-oestrogen

- Inhibits oestradiol from acting on oestrogen receptor.

23
Q

Side effects of tamoxifen

A

Menopausal symptoms

  • Vasmotor
  • Joint pain
  • Mood changes
  • VTE, endometrial cancer
24
Q

Aromatase inhibitors act as anti breast cancer therapy by…

A

Preventing peripheral production of oestrogen via aromatase enzymes

25
Q

Side effects of aromatase inhibitors

A

Arthralgia

Reduced bone density/ Increased fracture risk

26
Q

Anti-HER2 monoclonal antibodies are associated with what complication?

A

Heart failure

27
Q

Adjuvant bisphosphonatese reduced risk of… in _____ women

A

Reduces recurrence and death risk

In post-menopausal women

28
Q

Breast cancer typically metastases to what areas?

A

Lung

Bone

Brain

Liver

29
Q

Luminal breast cancers typically spreads to…

A

Bone

Skin

Lymph nodes

30
Q

_____ inhibitors describe targeted therapy for HER2+ and HR+ breast cancer

A

CDK4/6

31
Q

_______ is an adjunct that can be given to minimise the cytotoxic effects of chemotherapy

A

Antibody-drug conguates (ADCs)

32
Q

The most type of aggressive type of breast cancer is…

A

Triple negative breast cancer

33
Q

Management of bone mets in breast cancer

A

Bisphosphonates

RANKL inhibitor

34
Q

Triple negative breast cancer is treated with..

A

Chemo/ immunotherapy

PARP-inhibitors (BRCA+)

35
Q

Mutations involved in bowel cancer pathogenesis

A

APC

KRAS

DCC

TP53

36
Q

NICE guidelines for bowel cancer 2-week wait

A

> 40, unexplained weight loss + abdo pain

> 50, unexplained rectal bleeding

> 60, unexplained iron deficient anaemia/ change in bowel habit.

37
Q

______ as used for the bowel cancer screening programme

A

FIT tests

38
Q

What age group are screened for bowel cancer?

A

60-74

38
Q

What age group are screened for bowel cancer?

A

60-74

39
Q

Risk factors that indicate frequent bowel cancer screen

A

FAP

HNPCC

IBD

40
Q

High risk groups that are screened more frequently for colorectal cancer

A

Previous colerectal cancer

Colonic adenoma

IBD

Acromegaly

FMHs HNPCC/ FAP, Peutz jagher

Strong bowel cancer FHx

  • 2 first degree relatives
  • 1 first degree, <45.

402: OHP (9 decks)

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