Breast Cancer Flashcards
From which cells can breast cancer arise?
Ductal: Epithelial lining of ducts
Lobular: epithelium of terminal ducts of lobules
Where and what nature are most breast cancers?
Invasive ductal carcinoma
6 main RFs for breast cancer?
Age Prolonged exposure to oestrogen FH Genetics Previous breast, endometrial, ovarian or bowel Ca Irradiation to chest wall
5 features a patient may present with in breast cancer
Breast lump (~painless) Changes in breast shape Skin changes Nipple discharge (+/- bloody) Axillary lump
What signs of malignancy may present in breast cancer?
Weight loss
Bone pain
Paraneoplastic syndromes
How does being oestrogen receptor positive influence prognosis? Why?
Improves prognosis
Can be targeted by oestrogen receptor blocker e.g. tamoxifen
How does over expression of HER2 influence prognosis? Why?
Worsens diagnosis, aggressive disease
GF receptor gene: promotes growth of Ca cells
5 signs of breast cancer on examination?
Breast lump: Hard, Irregular surface, Indistinct borders, Fixed to surrounding structures
Peau d’orange
Skin tethering
Skin ulceration
Nipple inversion
Paget’s disease of the breast: eczema-like hardening of skin on nipple
Ix for breast cancer
Triple assessment:
Clinical examination
Imaging: US (< 35 yrs) OR Mammogram (> 35 yrs)
Tissue Diagnosis: FNA OR Core Biopsy
Where are the most common sites of metastases in breast cancer?
Lymph nodes
Lungs
Liver
Bone (spine)
After diagnosis, what further investigations are performed in breast cancer?
CXR Bloods inc. LFTs ER + PR status HER2 status CT + Bone scintigraphy if mets. suspected
What are the 4 stages of breast cancer?
1: Confined to breast, mobile
2: Confined to breast, mobile, LN in ipsilateral axilla
3: Tumour fixed to muscle (but not chest wall), ipsilateral LN matted + may be fixed, skin involvement larger than tumour
4: Complete fixation of tumour to chest wall, distant mets.
