Breast CA Flashcards
Having the BRCA1 or BRCA2 gene increases the lifetime risk of breast cancer by ?
60-80%
What are the presentations of breast cancer?
Lumps Bumps Skin changes Dimpling Red, hot Pain or no pain Regional node enlargement
Malignant cancers tend to have ____ nipple discharge
Less
What is the gold standard for evaluation of a mass to determine if it is solid or cystic?
Aspiration/biopsy
How do you diagnose breast cancer?
Aspiration/Biopsy
Mammogram
MRI
What is the number one reason for law suits between a woman and her medical provider?
Non-discovery or late discovery of breast cancer
When do you start doing mammograms before 40?
If there is a family history
If you have a postmenopausal woman with a dominant mass or asymmetry, what should you assume?
Presume cancerous until proven otherwise
If you find a solid dominant mass, what do you do?
Any solid mass ALWAYS warrants a definitive diagnosis, even if you can’t get an image with mammogram or US
When in doubt about a breast mass what do you do?
Aspirate and refer to surgeon!
What is the most common type of non-invasive breast CA?
Ductal carcinoma in situ
Is ductal carcinoma in situ life-threatening?
Nope, but can increase risk of developing invasive breast cancer
What is the treatment for DCIS?
Lumpectomy alone or lumpectomy and radiation
What is the most common type of breast CA (also the most common among men)?
Infiltrating ductal carcinoma
What type of breast cancer makes up 70-80% of all breast CA?
Invasive ductal carcinoma
If a patient presents with skin irritation or dimpling, breast pain, thickening of the nipple or breast skin, nipple discharge and/or an enlarged lymph in axilla, what should you suspect?
Invasive ductal carcinoma
How do you stage breast cancer?
- Size of the tumor
- Whether the cancer has spread to lymph nodes and how many
- Whether the cancer has spread to other parts of the body
- ER/PRHer2/neu status (?)
How do you treat IDC?
Surgery: Lumpectomy if less than 2cm Mastectomy Sentinel lymph node biopsy Axillary lymph node dissection
Also post surgical radiation
What are some systemic treatment options for IDC?
Chemo Hormonal therapy Estrogen receptor down regulators Ovarian shut-down or removal HER2 targeted therapies
What is the 2nd MC type of breast CA that makes up 10% of breast CA diagnoses?
Invasive lobar carcinoma
When does ILC tend to occur?
Later in life, early 60s
Inflammatory breast cancer is ?
Rare
How do you diagnose inflammatory breast cancer
Punch biopsy
What are the staging tests for inflammatory breast cancer?
CXR
CT scan of chest, abdomen, and pelvis
Bone scan
Liver function tests
