Breast Cancer Flashcards
define microinvasive carcinoma
DCIS with invasion <1mm
RF for invasive breast cancer
age early menarche no parity no breastfeeding late menopause hormones (OCP, HRT) previous lifestyle genetics
what lifestyle factors can reduce the risk of breast cancer?
physical activity
NSAIDs
cancer syndromes
BRCA1 and 2 Li Fraumeni syndrome (TP53) Cowden's syndrome (PTEN) Peutz-Jegher's syndrome ataxia telangiectasia
how is breast cancer classified?
according to receptor expression = ER, PgR, HER2 or triple negative
most common type of breast cancer?
ductal carcinoma
what do ER expression cancers respond to?
anti-oestrogen therapies
examples of anti-oestrogen therapies
oophorectomy
tamoxifen
aromatase inhibitors
GnRH agonists (goserilin)
presentation of breast cancer
lump
blood/ discharge from nipple
skin changes - texture/ colour
diagnosis of breast cancer
triple assessment
what kind of biopsy gets more tissue?
vacuum
how to check receptor expression
immunohistochemistry
FISH for HER2
surgical options
- WLE
- mastectomy
- reconstruction options
when is breast conservation surgery as good as mastectomy?
clear margins of >1mm
adjuvant radiotherapy post-op (started within 12 weeks)
reconstruction options
external prosthesis implants flaps nipple reconstruction lipo-modelling contralateral symmetrising
hormonal therapy options
aromatase inhibitors
tamoxifen
GnRH analogues e.g. goserelin
examples of aromatase inhibitors
letrozole
anastrozole
role of aromatase inhibitors
prevent formation of oestradiol from testosterone
side effects of aromatase inhibitors
joint/bone pain hot flushes fatigue weight gain mood swings
who can only use aromatase inhibitors?
post-menopausal women
role of tamoxifen?
blocks oestrogen receptors in breast tissues while stimulating it in uterus and bones preventing OP but increasing risk of endometrial cancer
adverse of trastuzumab?
headaches
blurred vision
heart function
management options of lymphoedema?
massage techniques compression exercises weight loss good skin care avoid inserting cannulas/taking bloods
what nerve is damaged in winged scapula?
serratus anterior
