breast - cancer

Question 1

most common type of breast cancer

Answer 1

ductal carcinoma

Question 2

who are ductal carcinomas in situ more common in

Answer 2

elderly

Question 3

who are lobular carcinomas in situ more common in

Answer 3

<40

Question 4

most common breast cancers

Answer 4

ductal carcinoma, lobular carcinoma, medullary, lymphoma, inflammatory

Question 5

symptoms inflammatory breast cancer

Answer 5

cancer cells block drainage –> inflamed breast

Question 6

symptoms breast cancer

Answer 6

irregular lump // discharge // nipple retraction // pagets // peau d’orange // skin dimpling

Question 7

genetics breast cancer

Answer 7

BRCA1, BRCA2, p53 gene

Question 8

RF brest caner

Answer 8

nullparity, first pregnancy >30 // early menarche, late menopause // combined HRT // COCP // obese

Question 9

definite referral breast cancer 2 week pathway

Answer 9

> 30 with unexplained lump +/- pain // >50 with unilateral discharge, retraction, or changes

Question 10

who is offered screening for breast cancer

Answer 10

women 50-70 // mammogram every 3 years

Question 11

best –> worst prognosis hormone receptors

Answer 11

ER+, PR+, HER2- // ER+, PR-, HER2- // ER-, PR-, HER2+ // ER-, PR-, HER2-

Question 12

where does breast cancer met too

Answer 12

bone, brain, liver, lung

Question 13

invx breast cancer

Answer 13

triple assessment

Question 14

who is offered surgery for breast cancer

Answer 14

almost all patients

Question 15

surgical approach to women with NO palpable axillary lymph nodes

Answer 15

USS before –> if positive sentinel node biospy

Question 16

surgical approach to women WITH palpable axillary lymph nodes

Answer 16

axillary node clearance

Question 17

complication of axillary node clearance

Answer 17

lymphedema and arm impairment

Question 18

what tumours are suitable for WLE

Answer 18

DCIS <4cm // solitary // peripheral // small lesion in large breast

Question 19

what tumours are suitable for masectomy

Answer 19

central tumour // multifocal // large lesion in small breast // >4cm

Question 20

what are all women offered after breast surgery

Answer 20

breast reconstruction

Question 21

who is offered radiotherapy after surgery

Answer 21

WLE: ALL women // mastectomy: if T3-T4 or 4 lymph nodes

Question 22

where are breast implants inserted

Answer 22

under pec major

Question 23

where is tissue taken from + what artery in lattimus dorsi breast reconstruction

Answer 23

skin + back // thoracodorsal artery

Question 24

where is tissue taken from + what artery in TRAM/ DIEP breast reconstruction

Answer 24

tissue from abdomen // TRAM is fat, DIEP is fat + muscle // inferior epigastric

Question 25

where is tissue taken from + what artery in IGAP breast reconstruction

Answer 25

skin and muscle from buttocks // inferior gluteal artery

Question 26

SE from radiotherapy

Answer 26

lung fibrosis // IHD // skin fibrosis

Question 27

when is chemo indicated for breast cancer pre surgery

Answer 27

prior to surgery to shrink a tumour for WLE

Question 28

when is chemo indicated for breast cancer post surgery

Answer 28

axillary node disease (FEDC used) // advanced stage

Question 29

which chemo drugs are usually used in breast cancer

Answer 29

5FU, methotrexate, Cyclophosphamide

Question 30

when is hormal therapy indicated

Answer 30

ER+ive cancer

Question 31

what hormonal therapy is used for pre vs post menopausal womem

Answer 31

pre = tamoxifen // post = aromatise inhib eg anastrozole OR tamoxifen

Question 32

when is immunotherapy indicated in breast cancer

Answer 32

HER2+

Question 33

what immunotherapy is used

Answer 33

trastuzumab (herceptin)

Question 34

symptoms pagets

Answer 34

eczma like breast change not responsive to steroids, starts in nipple

Question 35

invx pagets nipple

Answer 35

biopsy, mammogram, USS breast

Question 36

implication of pagets

Answer 36

90% invasive carcinoma