Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Breast > Breast cancer > Flashcards

Breast cancer Flashcards

1
Q

What is the second most common cause of death from cancer in the UK?

A

Breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Risk factors for breast cancer

A

(1) Female - 99%
(2) Increased oestrogen exposure
- -> early period, late menopause
- -> COCP, HRT (combined)
- -> nuliparity or late 1st pregnancy
(3) Family history (1st degree)
(4) Obesity
(5) Smoking + alcohol
(6) Caucasian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

1) What chromosome is BRCA1 gene found on?
2) What % will develop breast cancer by 80 years?
3) What % will develop ovarian cancer?

A

1) chromosome 17
2) 70%
3) 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What other cancers are associated with faulty BRCA1 gene?

A

bowel & prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Is the risk of breast cancer and ovarian cancer higher or lower with a faulty BRCA2 gene in comparison to a faulty BRCA1 gene?

A

Lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Most common form of breast tumour?

A

Ductal carcinoma –> if basement membrane isn’t breached = ductal carcinoma in situ (DCIS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What aged women are offered breast screening?

A

50-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does breast screening involve?

A

Mammogram (X-ray) every 3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Potential downsides of screening?

A
  • exposure to radiation
  • missed (false negatives) leading to false reassurance
  • false positives leading to emotional distress and unnecessary tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Benefits of breast screening?

A
  • early detection of cancer
  • 20% reduction in relative risk of death from breast cancer
  • peace-of-mind
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which patients should be referred along the URGENT cancer referral pathway (2 week wait) for breast cancer?

A

1) unexplained breast lump in 30+ year old

2) unilateral nipple changes in 50+ (discharge, retraction etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which patients should be considered for referral along the URGENT cancer referral pathway (2 week wait) for breast cancer?

A

1) unexplained axilla lump in 30+ year old

2) Skin changes suggestive of cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Who would you consider non-urgent referral for?

A

unexplained breast lump in <30 year old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What’s the triple assessment?

A

1) clinical (history/exam)
2) imaging (US or mammography)
3) biopsy (fine needle aspiration OR core biopsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What imaging is used for patients under 30? why?

A

US - good at distinguishing solid from cystic lumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What imaging is used for patients older women? why?

A

Mammogram - can pick up calcifications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When would you MRI?

A
  • screen high risk women e.g. strong FHx

- assess size and features of tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What other scans would you perform after diagnosing breast cancer?

A

US axilla + US-guided biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What imaging may be used during breast surgery to detect abnormal lymph nodes?

A

Sentinel Lymph node biopsy –> contrast and dye travels to the sentinal lymph node (1st lymph node)

20
Q

Clinical features suggesting breast cancer?

A

(1) Lumps are hard, irregular, painless or fixed in place
(2) Lumps are tethered to skin or chest wall
(3) Nipple retraction
(4) Peau d’orange - skin dimpling or oedema
(5) Assoc. lymphadenopathy (axilla)

21
Q

Main types of breast tumours?

A
  • Ductal carcinoma (in-situ or invasive) 75% of invasive
  • Lobular carcinoma (in-situ or invasive) 10% of invasive
  • Inflammatory breast cancer
  • Paget’s disease of the Nipple
22
Q

Rare types of breast cancer?

A
  • Medullary breast cancer (common w/ BRCA1)
  • Phyllodes Tumour
  • Mucinous breast cancer
  • Tubular breast cancer
23
Q

If strong family history patients are referred for genetic tests, what to do prior to this?

A
  • genetic counselling

- pre-test counselling

24
Q

What is offered to women with increased risk?

A

(1) Annual mammogram
(2) Chemoprevetion
- -> Tamoxifen if premenopausal
- -> Anastrozole if postmenopausal
(3) Risk-reducing surgery
- -> bilateral mastectomy
- -> bilateral oophorectomy

25
Q

When is anastrozole contraindicated?

A

Severe osteoporosis

26
Q

3 types of receptors?

A

(1) Oestrogen receptors (ER)
(2) Progesterone receptors (PR)
(3) Human epidermal growth factor (HER2)

27
Q

What is triple negative breast cancer

A

breast cancer cells don’t express any of the 3 receptors and carries worse prognosis.

28
Q

Who does NICE recommend receives gene expression profiling?

A

Early breast cancer that are: ER +ve but HER2 and lymph node -ve

29
Q

Where can breast cancer mets?

A

Anywhere but commonly:

(1) Lungs
(2) Liver
(3) Bones
(4) Brain

30
Q

How would you stage breast cancer?

A

TNM System:

  • Tumour size –> assess with imaging + histology biopsy
  • Node spread –> exam, sentinal lymph node biopsy
  • Mets –> US liver, CT thorax, abdo and pelvis, isotope scan for bony mets
31
Q

Surgical options for tumour removal?

A

(1) Breast-conserving surgery = e.g. wide local excision, coupled with RT
(2) Mastectomy = removal of whole breast tissue, coupled with reconstruction

32
Q

Risk of lymph node removal?

A

Chronic lymphoedema

33
Q

Why would you avoid cannulating arm w/ previous breast cancer/lymph node removal?

A

Higher risk of infection due to impaired lymphatic drainage

34
Q

Conservative management of lymphoedema?

A
  • massage techniques (manual lymphatic drainage)
  • compression bandage
  • weight loss if overweight
  • specific exercises
35
Q

Common radiotherapy side effects?

A
  • fatigue
  • skin changes –> irritation, colour change (darkens)
  • tissue changes - fibrosis, shrinking, swelling
36
Q

3 options for chemotherapy?

A

(1) Neoadjuvant - shrinks tumour BEFORE surgery
(2) Adjuvant - given after surgery to reduce recurrence
(3) Treatment - if metastatic OR recurrent

37
Q

Which hormone receptor would indicate chemotherapy?

A

HER2 over-expression

38
Q

Who is offered biological therapy? Name?

A

Trastuzumab (Herceptin) offered to HER2 positive

39
Q

What monitoring is required for Herceptin?

A

Monitor heart function (inital and during) due to side-effects:

  • cardiac dysfunction (HF)
  • teratogenecity
40
Q

Hormonal treatment options for ER receptor positive breast cancer?

A

(1) Anastrazole (aromatase inhibitor) if post-menopausal

(2) Tamoxifen (SERM) if pre-menopausal

41
Q

Mechanism of action of tamoxifen?

A
  • A selective oestrogen receptor modulator (SERM)
  • Blocks in breast tissue
  • Stimulates in uterus (increased risk endometrial cancer)
  • Stimulates in bones (reduced risk osteoporosis)
42
Q

How long are ER patients given tamoxifen or anastrazole?

A

5-10 years

43
Q

Reconstruction options following breast-conserving surgery?

A

(1) Partial reconstruction (fat/flap tissue replaces gap)

(2) Reduction + reshaping

44
Q

Reconstruction options following mastectomy?

A

(1) Breast implants

(2) Flap reconstruction

45
Q

Benefits of implants? Disadvantages?

A 
Minimal scarring & acceptable appearance
Feels unnatural (cold, less mobile) & long-term problems (hardening, leakage, shape change)
46
Q

What flaps are available for flap reconstruction?

A

(1) Latissimus dorsi –> pedicled OR free flap
(2) Transverse rectus abdominus (TRAM) –> pedicled OR free, hernia risk
(3) Deep inferior epigastric perforator (DIEP) –> free flap.

47
Q

What vessels are involved with a DIEP flap reconstruction?

A

Deep inferior epigastric artery in transplanted into breast. attached to the internal mammary artery and vein.

Breast (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions