Breast cancer Flashcards
Most common type
Invasive ductal carcinomas
Ductal carcinoma in situ
Pre-cancerous or cancerous epithelial cells of the breast ducts
Localised to a single area
Often picked up by mammogram
Potential to spread locally over years
Potential to become an invasive breast cancer
Good prognosis if full excised and adjuvant treatment is used
Lobular carcinoma in situ
A pre-cancerous condition occurring in typically in pre-menopausal women
Usually asymptomatic and undetectable on a mammogram
Usually diagnosed incidentally ob breast biopsy
Represents and increased risk of invasive breast cancer in the future
Often managed with close monitoring
Invasive ductal carcinoma- NST
Also known as invasive breast carcinoma of no special/ specific type
Originates in cells from the breast ducts
80% of invasive breast cancers fall into this category
Can be seen on mammograms
Invasive lobular carcinomas
Around 10% of invasive breast cancers
Originate in cells from the breast lobules
Not always visible on mammograms
Inflammatory breast cancer
1-3% of breast cancers
Presents similarly to breast abscess or mastitis
Swollen, warm, tender breast with peau d’orange
Does not respond to antibiotics
Worse prognosis than other breast cancers
Paget’s disease of the nipple
Looks like eczema of the nipple/ areolar
Erythematous, scaly rash
Indicates breast cancer involving the nipple
May represent DCIS or invasive breast cancer
Requires biopsy, staging and treatment
Rare types of breast cancer
Medullary breast cancer
Mucinous breast cancer
Tubular breast cancer
Breast cancer screening
Mammogram every 3 years for women aged 50-70
High risk patients
A first-degree relative with breast cancer under 40
A first-degree male relative with breast cancer
A first-degree relative with bilateral breast cancer, first diagnosed under 50 years
Two first-degree relatives with breast cancer
2 week wait referral
An unexplained breast lump in patients aged >30
Unilateral nipple changes in patients aged >50
Consider if
- unexplained axilla lump in patients >30
- skin changes suggestive of breast cancer
Predisposing factors
BRCA1/ BRCA2 genes
1st degree premenopausal relative with breast cancer
Nulliparity, 1st pregnancny >30
Early menarche, late menopause
Combined HRT and COCP
Past breast cancer
Non breastfeeding
Ionising radiation
Obesity
Triple assessment
Clinical assessment
Imaging
Biopsy
Imaging
Younger women have more dense breasts with more glandular tissue
US scans in younger women- distinguish solid from cystic lumps
Mammograms in older women- can pick up calcifications missed by US
MRI to further assess
Lymph node assessment
US of axilla and IS guided biopsy of any abnormal notes
Sentinel lymph node biopsy during surgery
