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Breast > Breast cancer > Flashcards

Breast cancer Flashcards

1
Q

Does the COCP increase the risk of breast cancer?

A

Yes - small increase in risk of breast cancer (but risk returns to normal 10 years after stopping the pill)

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2
Q

Does HRT increase the risk of breast cancer?

A

Yes (particularly combined HRT)

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3
Q

Which genes are associated with an increased risk of breast cancer?

A

BRCA1 and BRCA2

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4
Q

Which types of breast cancer do I need to know about?

A
  • Ductal carcinoma in situ (DCIS)
  • Lobular carcinoma in situ (LCIS)
  • Invasive ductal carcinoma
  • Invasive lobular carcinoma
  • Inflammatory breast cancer
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5
Q

Which type of invasive breast cancer is more common, invasive ductal carcinoma or invasive lobular carcinoma?

A

Invasive ductal carcinoma (80% of invasive breast cancers)

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6
Q

How common is inflammatory breast cancer?

A

Rare (it represents 1-3% of all breast cancers)

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7
Q

What is Paget’s disease of the nipple? Is this associated with a specific type of breast cancer?

A

Paget’s disease of the nipple is an erythematous, scaly rash affecting the nipple (which indicates breast cancer involving the nipple, e.g. DCIS)

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8
Q

How often does the NHS breast cancer screening programme offer a mammogram? Between which ages is breast cancer screening offered?

A

Every 3 years, between the ages of 50-70 years

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9
Q

What type of preventative measures may be offered in high risk patients? (e.g. patients with first-degree relative with breast cancer under 40 years)

A
  • Genetic testing (BRCA1 and BRCA2)
  • Annual mammogram
  • Chemoprevention (e.g. tamoxifen)
  • Risk-reducing bilateral mastectomy/oophorectomy
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10
Q

Describe the two-week wait referral criteria for suspected breast cancer

A
  • Unexplained breast/axillary lump in patients ages 30+
  • Unilateral nipple changes in patients aged 50+
  • Skin changes suggestive of breast cancer
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11
Q

What are the skin changes suggestive of breast cancer?

A
  • Paget’s disease of the nipple (erythematous scaly rash affecting the nipple)
  • Peau d’orange (skin dimpling and oedema)
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12
Q

What is meant by “triple diagnostic assessment” in suspected breast cancer?

A
  1. Clinical assessment (history and examination)
  2. Imaging
  3. Biopsy
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13
Q

What type of imaging is typically used in…

a) Young women
b) Older women

A

a) USS

b) Mammography

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14
Q

Breast cancer cells may have receptors that can be targeted with breast cancer treatments. What are the three types of receptor?

A
  • Oestrogen receptor (ER)
  • Progesterone receptor (PR)
  • Human epidermal growth factor (HER2)
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15
Q

What is meant by triple negative breast cancer? Describe the prognosis

A

Breast cancer cells do not express any of the three receptors (ER, PR, HER2) - this typically carries a worse prognosis as treatment options are more limited

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16
Q

Which locations does breast cancer commonly metastasise to?

A

2 Ls and 2 Bs:

  • Liver
  • Lung
  • Bone
  • Brain
17
Q

Breast cancer is graded using which system?

A

TNM (tumour, node, metastasis)

18
Q

What are the two surgical options available when removing a breast cancer?

A
  1. Breast-conserving surgery (usually coupled with radiotherapy)
  2. Mastectomy
19
Q

When is axillary clearance performed?

A

When sentinel lymph node biopsy shows evidence of cancer cells

20
Q

Axillary clearance increases the risk of which adverse effect?

A

Chronic lymphoedema in that arm

21
Q

What are the three scenarios for using chemotherapy in breast cancer?

A
  1. Neoadjuvant (aim of shrinking the tumour before surgery)
  2. Adjuvant (given after surgery to reduce risk of recurrence)
  3. Treatment (e.g. metastatic breast cancer)
22
Q

What hormonal treatment is given in oestrogen-receptor positive breast cancer? Does this differ in different age groups?

A
  • Premenopausal women are treated with tamoxifen

- Postmenopausal women are treated with letrozole or anastrozole

23
Q

Which class of drug does tamoxifen belong to? Describe its mechanism of action

Tamoxifen can increase the risk of which type of cancer?

A

SERM (selective oestrogen receptor modulator) - it blocks oestrogen receptors in breast tissue and stimulates oestrogen receptors in the uterus and bones

Endometrial cancer

24
Q

Which class of drug do letrozole and anastrozole belong to? Describe its mechanism of action

A

Aromatase inhibitor - block the creation of oestrogen in fat tissue

25
Q

How long are hormonal treatments typically prescribed for in women with oestrogen receptor positive breast cancer?

A

5-10 years

26
Q

Which drugs may be prescribed in a patient with HER2 receptor positive breast cancer?

A
  • Herceptin (trastuzumab)

- Perjeta (pertuzumab)

27
Q

Aromatase inhibitors (e.g. letrozole, anastrozole) are associated with an increased risk of…

A

Osteoporosis

Breast (6 decks)

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