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3rd Year Semester 1 > Breast cancer > Flashcards

Breast cancer Flashcards

1
Q

breast tissue is made up of

A

glandular tissue arranged multiple lobes made up of lobules

lobules are divided by fibrous ligaments (coopers ligaments)

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2
Q

breast tissue is

A

mammary gland that lies over pectoralis major muscle

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3
Q

what ribs does breast extends from

A

2-6 rib

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4
Q

Lymph Nodes of breast

A

level 1 nodes - low axilla
level 2 nodes - midaxilla
level 3 nodes - apical axilla
supraclavical nodes
internal mammary

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5
Q

genes most commonly affected in hereditary breast cancer

A

BRCA1
BRCA2
Li fraumeni syndrome (LFS)

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6
Q

BRCA1

A

85% risk of breast cancer
60% risk of ovarian cancer

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7
Q

BRCA2

A

60% risk breast cancer
risk of prostate, non hodgkins lymphoma ,pancreas and bladder cancer

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8
Q

LFS

A

50% risk breast cancer

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9
Q

Family History-Exposure to Oestrogen
Endogenous

A

Low parity
first born child at less than 30 years
early menarche (under 11 years)
late menopause (after 54)

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10
Q

Family History-Exposure to Oestrogen
Exogenous

A

hormone replacement therapy - longterm
oral contraceptive treatment

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11
Q

Other risk factors:

A

western style diet
alcohol consumption
obesity
high breast density and history of atypical hyperplasia
exposure to ionizing radiation
age :75% over the age of 50 and 5% before 35

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12
Q

Signs and Symptoms

A

1.painless or slightly tender bump
2.abnormal mammography
3.changes in size /shape/skin
4.bloody nipple discharge
5.Axillary Lymphadenopathy (under arm lymph nodes enlarge)
6.symptoms of metastatic disease

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13
Q

a patient with a breast lump

A

if a discrete lump is found by gp, patient is referred to symptomatic breast clinic

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14
Q

Diagnosis –Triple Assessment

A

1) clinical assessment (breast exam)
2)radiology
3)pathology

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15
Q

Triple Assessment- Clinical

A

medical history
examination of breast
may score using 1-5 system for consistency

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16
Q

Radiographic studies

A

bilateral mammogram
+/- ultrasound
+/- CXR
+/- plain radiographs -symptomatic bone
MRI breast

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17
Q

Screening mammography

A

two standard xray images of each breast

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18
Q

diagnostic mammogram

A

spot compression(focuses on small area that was supsicious on first mammogram) and magnifies views

detects tumour 5mm or less

defines status of both breast

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19
Q

Breast Density

A

unrelated to breast size and not detected on clinical exam

more common in young ,breastfeeding women or those on HRT

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20
Q

Ultrasound

A

good at differentiating between tumours and cysts

21
Q

MRI-Breast
recommended…

A

-uncertainty following standard imaging
-special clinical situations

22
Q

MRI-Breast
used if patient has

A

dense breast
breast implants
suspicsion of lobular cancer
familial breast cancer - with or without BRCA mutations

23
Q

pathology
recommended

A

if clinical or imaging findings are suspicious or suggestive of malignancy

24
Q

types of biopsy

A

fine needle aspiration

core needle

25
Q

fine needle aspiration biopsy

A

small bore needle that obtains CELL SAMPLE from breast
minimally invasive and low cost

26
Q

core needle biopsy

A

removes multiple cores of solid tissue
uses image guidance /palpations eg MRI or ultrasound

27
Q

core biopsy

A

B1 =normal
B2 =benign
B3 =uncertain
B4 =suspicous
B5a =DCIS (ductal carcinoma in situ)
B5b= invasive

28
Q

excisional biopsy

A

removal of entire breast mass or a suspicious area

29
Q

breast cancer is classified by

A

-whether the cancer started in the lobules or ducts
-if cells invaded thru lobules or ducts
-microscopic appearance of cancer cells

30
Q

Almost all are carcinomas arising

A

from wall of ducts

31
Q

PATHOLOGIC CLASSIFICATION

A

ductal
lobular
other

32
Q

ductal

A

-intra-ductual carcinoma in situ DCIS
-invasive/infilterating

33
Q

lobular

A

in situ LBIS
invasive/ infilterating

34
Q

other

A

nipple (pagnents disease)
inflammatory
medullary

35
Q

most common pathogical classification

A

infiltrating ductal carcinoma 75-80%
infilrating lobular 10%
DCIS 3-5%

36
Q

Tumour grade:
Scarff-Bloom-Richardson Grade System
GRADE 1

A

well-differentiated breast cells,
cells appear normal and rapidly growing

SCORE : 3,4,5

37
Q

Tumour grade:
Scarff-Bloom-Richardson Grade System
GRADE 2

A

moderately differentiated cells

SCORE 6,7

38
Q

Tumour grade:
Scarff-Bloom-Richardson Grade System
GRADE 3

A

poorly differentiated cells
cells dont appear normal
grow and spread more agressively
SCORE: 8,9

39
Q

Prognostic factors of breast cancer

A

tumour size/stage
histological grade
lymph node status
lymphovascular invasion
menopausal status

40
Q

hormone-receptor positive cancer definition

A

cancer cells have extra receptors that attach to oestrogen and progesterone

41
Q

type of Breast Cancer Hormone Receptors

A

ER-positive
PR-positive
hormone receptor- positive
hormone receptor - negative

42
Q

ER positive
PR positive

A

have esotrogen receptors
have progesterone receptors

43
Q

hormone receptor- positive
hormone receptor - negative

A

if cancer cell has one or both ( e or p)
if cancer cell has no hormone receptor

44
Q

HER2 stands for

A

human epidermal growth.

this means tumour cells make high levels of protein called HER2/neu … associated with certain aggressive types of breast cancer

45
Q

Triple Negative Breast Cancer refers to

A

cancer cells have no progesterone or estrogen receptors or the HER2 protein

46
Q

Features of Triple Negative Breast Cancer

A

poorer prognosis
agressive tumour
limited tx options

47
Q

Peau d’Orange

A

orange peel appearance created by

invasion of axillary lymphatics by tumour, producing obstructions and oedema of overlying skin

48
Q

Inflammatory Breast Cancer:
what is it
patients present w

A

very aggressive type of locally advanced breast cancer w poor prognosis

onset odema and erythema of breast skin

3rd Year Semester 1 (55 decks)

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