Breast cancer Flashcards
Name 2 risk factors for developing 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
- Hormone replacement therapy (esp. combined HRT)
1) What kind of gene is BRCA?
2) As well as breast cancer, name a cancer that having the BRCA1 gene increases the risk of
3) As well as breast cancer, name a cancer that having the BRCA2 gene increases the risk of
1) Tumour suppressor gene
2) Bowel ,ovarian, prostate testicular
3) Ovarian
Types (1)
1) Ductal Carcinoma In Situ (DCIS) is a cancer of what cells?
2) Lobular Carcinoma In Situ (LCIS) typically occur in which group of women?
3) Which of these is more likely to be picked up on a mammogram?
1) Epithelial cells of the breast ducts
2) Pre-menopausal
3) DCIS
Types (2)
1) Invasive Ductal Carcinoma of non specific type originates from cells where?
2) Invasive Lobular Carcinomas (ILC) originates from cells where?
3) Which of these invasive tumours are more common?
4) Which of these tumours can be seen on a mammogram?
1) Breast ducts
2) Breast lobules
3) IDC
4) IDC
Types (3)
Paget’s Disease of the Nipple and inflammatory breast cancer are 2 other, rarer causes of breast cancer
1) Which of these can appear as eczema?
2) Which of these can present as a scaly rash?
3) Which of these present as swollen, warm, tender breast with pitting skin
4) Which of these have a worse prognosis than most other breast cancers?
1) Paget’s Disease of the Nipple
2) Paget’s Disease of the Nipple
3) Inflammatory breast cancer
4) Inflammatory breast cancer
1) What is the current breast cancer screening programme in the UK?
2) Name 2 downsides to cancer screening
1) Mammogram every 3 years to women aged 50 – 70 years
2) Anxiety and stress, exposure to radiation, missing cancer (false reassurance)
Name 2 ways breast cancer may present
- Lumps that are hard, irregular, painless or fixed in place
- Lumps may be tethered to the skin or the chest wall
- Nipple retraction
- Skin dimpling or oedema
- Lymphadenopathy (esp. axilla)
1) What investigation is typically used to assess lumps in younger women?
2) This investigation is helpful when distinguishing between what?
3) What investigation is typically more useful for older women?
4) What can this investigation pick up that ultrasound can’t?
1) Ultrasound
2) Solid lumps (i.e. cancer) from cystic (fluid-filled) lumps
3) Mammogram
4) Calcification
1) What are the 3 main types of receptors that may be on breast cancer cells?
2) If a breast cancer doesn’t have any of these cells, is the prognosis better or worse, and why?
1) Oestrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor (HER2)
2) Worse - limited treatment options
Breast cancers can spread to anywhere in the body, but name the 4 main locations
- Liver
- Lungs
- Brain
- Bones
Treatment (1)
1) What are the main 2 surgical option for breast cancer treatment?
2) Sometimes, axillary lymph nodes will also be removed. What is a potential side effect of this?
3) When might radiotherapy be involved in the management of breast cancer, and why might it be used?
4) In the management of breast cancer, what are the 3 scenarios chemotherapy may be used in?
1) Mastectomy, breast conserving surgery
2) Chronic lymphoedema
3) Patients with breast-conserving surgery to reduce the risk of recurrence
4) Neoadjuvant (before surgery), adjuvant (after surgery) or treatment
Treatment (2)
1) For postmenopausal women with oestrogen-receptor positive breast cancer, what drug group can be used, and give an example?
2) For premenopausal women with oestrogen-receptor positive breast cancer, what is the 1st line drug?
1) Aromatase inhibitors i.e. letrozole, anastrozole or exemestane
2) Tamoxifen
Treatment (3)
1) What type of drug is tamoxifen, and how does it work?
2) Name another benefit of this drug
3) Name a side effect of this drug
4) How do aromatase inhibitors work?
5) How long is tamoxifen or an aromatase inhibitor given to women with oestrogen receptor positive breast cancer for?
6) What are the 2 monoclonal antibodies that may be given together for HER2 receptor positive breast cancers?
1) Selective oestrogen receptor modulator - it blocks oestrogen receptors in breast tissue however it stimulates oestrogen receptors in the uterus and bones
2) Osteoporosis
3) Can increase risk of endometrial cancer
4) Aromatase is an enzyme in fat that converts androgens to oestrogen - aromatase inhibitors inhibit this
5) 5-10 years
6) Trastuzumab and pertuzumab
What are the 2 scenarios where you’d refer someone for a 2WW pathway for breast cancer
- 30 and older with an unexplained breast lump with or without pain OR
- 50 and older with any of the following symptoms in 1 nipple only - pain, retraction or other symptoms of concern
