Breast cancer Flashcards
Define breast cancer
& most common type
Malignancy of breast tissue
Most common type: invasive ductal carcinoma
Aetiology of breast cancer
2
Genetics (e.g. BRCA-1 & BRCA-2 genes)
Environmental factors
Risk factors for breast cancer
3
Age
Prolonged exposure to oestrogen
FH of breast cancer
Prolonged exposure to oestrogens by…
6
Nulliparity (no children) Early menarche Late menopause Obesity COCP HRT
Epidemiology of breast cancer
prevalence, age
Most common cancer in women
Peak age 40-70 yrs
Presenting symptoms of breast cancer
5
Breast lump (usually painless) Changes in breast shape Nipple discharge (may be bloody) Axillary lump Symptoms of malignancy - weight loss, bone pain, paraneoplastic syndromes
Signs of breast cancer on physical examination
7
Breast lump firm irregular fixed to surrounding structures Peau d’orange Skin tethering Fixed to chest wall Skin ulceration Nipple inversion Paget’s disease of the nipple
Define Paget’s disease of the nipple
Eczema like hardening on skin of nipple
Usually caused by ductal carcinoma in situ infiltrating the nipple
Investigations for breast cancer
4 groups
TRIPLE ASSESSMENT
Sentinel lymph node biopsy
Staging
Bloods
Investigations for breast cancer - triple assessment
3
Clinical examination Imaging US (<35yrs) OR mammogram (>35yrs) Tissue diagnosis fine needle aspiration OR core biopsy
Investigations for breast cancer - sentinel lymph node biopsy
(2)
Radioactive tracer is ejected into tumour & scan identifies sentinel lymph node
Node is then biopsied to check extent of spread
Investigations for breast cancer - staging
3
CXR
Liver US
CT (brain/thorax)
Investigations for breast cancer - bloods
6
FBC U&Es Calcium Bone profile LFTs ESR
