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Women's Health Clin med > Breast cancer > Flashcards

Breast cancer Flashcards

1
Q

What is the number one cause of cancer in women

A

breast cancer

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2
Q

What is the median age of diagnosis for breast cancer

A

63

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3
Q

What are some risk factors for developing breast cancer

A

increased lifetime exposure to estrogen

early menarche
late menopause
advanced maternal age

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4
Q

What are some protective factors of breast cancer

A

lack of ovaries
no prior HRT
Early menopause
longer duration of breast feeding
early age of first pregnancy
low dose ASA

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5
Q

Where on the breast is breast cancer most common

A

outer, upper quadrant

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6
Q

How is breast cancer classified

A

histologic type

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7
Q

What are the histological types of breast cancer

A

non-invasive
invasive
Paget carcinoma
inflammatory carcinoma

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8
Q

what is the most common type of breast cancer

A

infiltrative ductal carcinoma

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9
Q

Which types of breast cancer have a better prognosis

A

ER/PR positive tumors

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10
Q

What control hormone responsiveness in breast cancer

A

HER2/neu (+/-)
Estrogen ER (+/-)
Progesterone PR(+/-)

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11
Q

Which type of breast cancer has the worst prognosis

A

triple negative tumors

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12
Q

Who are triple negative tumors most common in

A

<40
Black
BRCA1+

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13
Q

Which BRCA gene is more likely to cause breast cancer

A

BRCA 1
(typically triple negative)

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14
Q

Who are BRCA driven breast cancer most common in

A

Ashkenazi jewish

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15
Q

What are the indications for BRCA screening

A

Breast cancer in 2+ first degree relatives

+FH prior to age 50
+FH ovarian cancer
+FH male breast cancer
1st degree w/ bilateral breast CA
breast + ovarian CA in 1 individual
Ashkenazi Jew ancestry

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16
Q

What are the common signs and symptoms for breast cancer

A

painless, palpable lump that is firm and has ill defined margins

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17
Q

What are the symptoms for Paget carcinoma

A

Starts as nipple itching/burning

often misdiagnosed as dermatitis/bacterial infection

Often no discrete breast mass

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18
Q

What are the symptoms of inflammatory carcinoma

A

Rapidly growing, large, painful mass
breast enlargement
often misdiagnosed as infection (then wont respond to abx)

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19
Q

Does the USPSTF recommend teaching self breast exams?

A

no

*just wants them aware of what is normal so they can report any changes

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20
Q

What is the gold standard for screening for breast cancer

A

mammography

21
Q

What age range should have screenings for breast cancer and how often

A

women 40-74, every 2 years

22
Q

How are mammography results reported

A

via BIRADS SCORE

23
Q

What are the most commonly identified abnormalities seen on breast exams

A

calcifications

24
Q

What abnormality on breast imaging is most likely malignant

A

<.5mm
various sizes / shapes
clustered in 1 area

25
Q

What is US useful in differentiating between in regards to

A

cystic vs solid masses

26
Q

which patients will get an MRI for their breast imaging

A

negative mammo but still suspicious

more info needed

breast implants

adjunct to mamma if high risk

27
Q

What type of biopsy is is preferred when working up a breast cancer

A

core needle because it is less prone to sampling error

*able to test for HER2/neu, ER, PR

28
Q

What are the following steps if there is a concern for advanced disease

A

CXR to eval for lung mets
Abdominal CT for liver mets
+/- PET scan
+/- DEXA

29
Q

What are the common metastatic locations with breast cancer

A

Liver
lung
bone
brain

30
Q

Which form of breast cancer is most likely to lead to brain mets

A

Triple negative
HER2/neu

31
Q

If clustered pleomorphic micro calcifications are seen on a mammogram, what are you concerned for

A

Breast cancer

32
Q

What are the stages of breast cancer

A

0 - abnormal cells
1- early stage
2- localized
3- regional spread
4 - distant spread

33
Q

What are the primary treatment strategies for breast cancer

A

Surgical resection + axillary lymph node dissection or sentinel node biopsy

radiation

34
Q

What is the first line treatment for stage 1 and 2 breast cancer

A

breast conserving lumpectomy

35
Q

What are the contraindications for breast conserving lumpectomy

A

> 4cm
multifocal
fixation to chest wall
skin involvement

36
Q

What is a mastectomy

A

Removal of entire breast, overlying skin, nipple/areola, and pectorals fascia

37
Q

What is the major advantage for a mastectomy

A

may not need radiation

38
Q

When is Chemo useful with breast cancer

A

Reduces recurrence and mortality for all stages EXCEPT stage 4

39
Q

Which age group is most benefited by chemo for breast cancer

A

patients < 50

40
Q

How long is a chemo treatment with breast cancer

A

3-6 months

41
Q

What are common side effects to chemo

A

N/V
Infertility
Premature ovarian failure

42
Q

What are less common but important side effects of chemo

A

Neutropenia
Cardiomyopathy
peripheral neuropathy
leukemia
cognitive dysfunction

43
Q

What are some anti-HER2 treatments

A

Mab drugs (pertuzumab)
Kinase inhibitors (Neratinib)

44
Q

What are some hormonal treatments with breast cancer

A

tamoxifen (SERM)
aromatase inhibitor (letrozole)
Bisphosphonates (early stages)

45
Q

Which age group are more susceptible to aggressive breast cancer / worse prognosis

A

Younger patients

46
Q

How often to women who have had breast cancer need to be evaluated

A

q6 months for 2 years, then annual exams

47
Q

What is the average age for breast cancer in men

A

70

48
Q

What symptoms will men present with with breast cancer

A

gynecomastia
nipple discharge

49
Q

What is the most common cause of breast cancer in men

A

ER positive (tomoxifen is used)

Women's Health Clin med (13 decks)

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