breast cancer Flashcards
(30 cards)
what is the sentinal lymph node?
sentinel lymph node is the axillary lymph node to which the breast cancer metastasises to first
what is the histology of most breast cancers?
adenocarcinoma
how can breast cancers be catagorised?
site: ductal or lobular
Invasion of basement membrane (BM):
In-situ: no invasion of the BM
Invasive: invasion of the BM
how can breast cancers be catagorised?
site: ductal or lobular
Invasion of basement membrane (BM):
In-situ: no invasion of the BM
Invasive: invasion of the BM
what are the types of carcinoma insitu and what are their clinical presentions?
- ductal carcinoma insitu- no mass but can see calcification on mamography
- lobular carcinoma insitu- normal mamography and discovered incidentally when breast is biospied for alternative reasons
what are the types of invasive carcinoma?
- invasive ductal carcinoma (NST): most common, presents as a mass clinically or on screening
- Invasive lobular carcinoma : not always visible on mamography. lack of E-cadherin on histology
- inflamatory breast cancer: presents similarly to mastitis but doesnt respond to antibiotics. swollen, warm, tender with peau dorange. worse prognosis
- pagets disease of the nipple
which type of cancer is associated with BRACA1?
medullary carcinoma
what are the risk factors for breast cancer?
Female (99% of breast cancers)
Increased oestrogen exposure (earlier onset of periods and later menopause)
More dense breast tissue (more glandular tissue)
Obesity
Smoking
Family history (first-degree relatives
how does COCP affect risk of breast cancer?
combined contraceptive pill gives a small increase in the risk of breast cancer, but the risk returns to normal ten years after stopping the pill.
how does HRT affect breast cancer?
Hormone replacement therapy (HRT) increases the risk of breast cancer, particularly combined HRT (containing both oestrogen and progesterone).
what things are protective against breast cancer?
- breast feeding and multiparity
- because reduces exposure to oestrogen
what are the different genetic risk factors for breast cancer?
BRCA1/ BRCA 2 mutation: tumour suppressor gene involved in DNA repair
Increased risk of breast and ovarian cancer
Most common cause of hereditary breast cancer
Male breast cancer associated with BRCA2
Li-Fraumeni syndrome: autosomal dominant p53 mutation
Breast, brain, adrenal, leukaemia/lymphoma, osteosarcoma
Peutz-Jeghers syndrome
Benign intestinal hamartomas and malignancies involving GI tract, breast, pancreas, and GU tract
Klinefelter syndrome: 47 XXY
Increased risk of breast cancer in men
which chromososme is BRACA1 on?
17
what are the different types of breast cancer receptor?
Oestrogen receptors (ER) Progesterone receptors (PR) Human epidermal growth factor (HER2)
Triple-negative breast cancer is where the breast cancer cells do not express any of these three receptors. This carries a worse prognosis, as it limits the treatment options for targeting the cancer.
what are the different types of breast cancer receptor?
Oestrogen receptors (ER) Progesterone receptors (PR) Human epidermal growth factor (HER2)
where do breast cancers metastasise?
L – Lungs
L – Liver
B – Bones
B – Brain
what does the tripple diagnostic assessment entail when a patient is referred on a 2WW?
Clinical assessment (history and examination)
Imaging (ultrasound or mammography)
Biopsy (fine needle aspiration or core biopsy)
what are the staging tests which are done after a diagnosis of breast cancer is made?
Lymph node assessment and biopsy
MRI of the breast and axilla
Liver ultrasound for liver metastasis
CT of the thorax, abdomen and pelvis for lung, abdominal or pelvic metastasis
Isotope bone scan for bony metastasis
what are the surgical options for treating breast cancer?
Breast-conserving surgery (e.g., wide local excision), usually coupled with radiotherapy
Mastectomy (removal of the whole breast), potentially with immediate or delayed breast reconstruction
axillary clearance-> increases risk of chronic lymphodema, especially if all axilliary lymph nodes are cleared
why should you avoided taking bloods or inseting a cannula into the side of breast surgery?
This is because there is a higher risk of complications and infection due to the impaired lymphatic drainage on that side.
what is the nottingham prognostic index?
This is a score which can be used to estimate 5-year survival
how does hormone status affect prognosis of breast cancer?
Hormone positive (ER and/or PR) carries a better prognosis than hormone negative
Triple-negative tumours are associated with a poor prognosis
how does HER2 status affect breast cancer?
HER-2 positive tumours show aggressive growth compared to HER-2 negative
who is ussually affected by tripple negative breast cancer?
African or Hispanic ethnicity
Younger patients
BRCA1 mutation
