Breast cancer Flashcards
(27 cards)
Does the COCP increase the risk of breast cancer?
Yes - small increase in risk of breast cancer (but risk returns to normal 10 years after stopping the pill)
Does HRT increase the risk of breast cancer?
Yes (particularly combined HRT)
Which genes are associated with an increased risk of breast cancer?
BRCA1 and BRCA2
Which types of breast cancer do I need to know about?
- Ductal carcinoma in situ (DCIS)
- Lobular carcinoma in situ (LCIS)
- Invasive ductal carcinoma
- Invasive lobular carcinoma
- Inflammatory breast cancer
Which type of invasive breast cancer is more common, invasive ductal carcinoma or invasive lobular carcinoma?
Invasive ductal carcinoma (80% of invasive breast cancers)
How common is inflammatory breast cancer?
Rare (it represents 1-3% of all breast cancers)
What is Paget’s disease of the nipple? Is this associated with a specific type of breast cancer?
Paget’s disease of the nipple is an erythematous, scaly rash affecting the nipple (which indicates breast cancer involving the nipple, e.g. DCIS)
How often does the NHS breast cancer screening programme offer a mammogram? Between which ages is breast cancer screening offered?
Every 3 years, between the ages of 50-70 years
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)
- Genetic testing (BRCA1 and BRCA2)
- Annual mammogram
- Chemoprevention (e.g. tamoxifen)
- Risk-reducing bilateral mastectomy/oophorectomy
Describe the two-week wait referral criteria for suspected breast cancer
- Unexplained breast/axillary lump in patients ages 30+
- Unilateral nipple changes in patients aged 50+
- Skin changes suggestive of breast cancer
What are the skin changes suggestive of breast cancer?
- Paget’s disease of the nipple (erythematous scaly rash affecting the nipple)
- Peau d’orange (skin dimpling and oedema)
What is meant by “triple diagnostic assessment” in suspected breast cancer?
- Clinical assessment (history and examination)
- Imaging
- Biopsy
What type of imaging is typically used in…
a) Young women
b) Older women
a) USS
b) Mammography
Breast cancer cells may have receptors that can be targeted with breast cancer treatments. What are the three types of receptor?
- Oestrogen receptor (ER)
- Progesterone receptor (PR)
- Human epidermal growth factor (HER2)
What is meant by triple negative breast cancer? Describe the prognosis
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
Which locations does breast cancer commonly metastasise to?
2 Ls and 2 Bs:
- Liver
- Lung
- Bone
- Brain
Breast cancer is graded using which system?
TNM (tumour, node, metastasis)
What are the two surgical options available when removing a breast cancer?
- Breast-conserving surgery (usually coupled with radiotherapy)
- Mastectomy
When is axillary clearance performed?
When sentinel lymph node biopsy shows evidence of cancer cells
Axillary clearance increases the risk of which adverse effect?
Chronic lymphoedema in that arm
What are the three scenarios for using chemotherapy in breast cancer?
- Neoadjuvant (aim of shrinking the tumour before surgery)
- Adjuvant (given after surgery to reduce risk of recurrence)
- Treatment (e.g. metastatic breast cancer)
What hormonal treatment is given in oestrogen-receptor positive breast cancer? Does this differ in different age groups?
- Premenopausal women are treated with tamoxifen
- Postmenopausal women are treated with letrozole or anastrozole
Which class of drug does tamoxifen belong to? Describe its mechanism of action
Tamoxifen can increase the risk of which type of cancer?
SERM (selective oestrogen receptor modulator) - it blocks oestrogen receptors in breast tissue and stimulates oestrogen receptors in the uterus and bones
Endometrial cancer
Which class of drug do letrozole and anastrozole belong to? Describe its mechanism of action
Aromatase inhibitor - block the creation of oestrogen in fat tissue
