Breast Cancer

Question 1

Risk Factors of Breast Carcinoma (8).

Answer 1

1. Increasing Lifetime Oestrogen Exposure.
2. Family History.
3. Alcohol.
4. Smoking.
5. More Glandular/Dense Tissue.
6. Ionising Radiation.
7. Not Breastfeeding.
8. Previous Breast Cancer.

Question 2

Give 8 causes of Increasing Lifetime Oestrogen Exposure.

Answer 2

1. Age.
2. Family.
3. Obesity.
4. Early Menarche.
5. Late Menopause.
6. Long-Term COCP Use (small increased risk that returns to normal 10 years after stopping use).
7. HRT Use for More than 10 Years (especially combined).
8. Nulliparity/1st Pregnancy After 30.

Question 3

Family History of Breast Carcinoma (3).

Answer 3

1. Important - Especially 1st Degree Relatives.
2. 5-10% of breast cancers are familial.
3. 85% - due to germline BRCA mutations.

Question 4

Genetics of Breast Carcinoma (4).

Answer 4

1. BRCA = Breast Cancer (Tumour Suppressor Gene) mutations - inherited in an autosomal dominant manner.
2. BRCA1 = Chromosome 17.
3. BRCA2 = Chromosome 13.
4. Other Genetics. :TP53 and PTEN.

Question 5

Epidemiology of Breast Carcinoma (3).

Answer 5

1. Commonest Cancer in the UK.
2. 1 in 8 women.
3. Rare before 25 + commonest between 40 and 70.

Question 6

Differential Diagnoses of a Breast Lump (2).

Answer 6

1. Fibroadenoma - Young Woman.

2. Cancer - Old Woman.

Question 7

Where is the commonest site of breast cancers?

Answer 7

Upper Outer Quadrant - because it has the greatest proportion of breast parenchymal tissue.

Question 8

What its the cause of Peau d’orange?

Answer 8

Cutaneous oedema, secondary to dermal lymphatic obstruction.