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breast surgery > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What are risk factors?

A

Being female
Increased oestrogen exposure
HRT - combined especially
Obesity
Smoking
Family history
More dense breast tissue
COCP

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2
Q

What are BRCA genes

A

Tumour suppressor genes

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3
Q

What chromosome is the BRCA 1 gene found

A

17

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4
Q

What other cancers do mutations of the BRCA 1 gene increase risk of ?

A

Ovarian
Bowel
Prostate

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5
Q

What chromosome is BRCA2 gene found on?

A

13

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6
Q

What other cancers does BRCA 2 predispose you to?

A

Ovarian cancer

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7
Q

What are the two types of carcinoma in situ

A

Ductal and lobular

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8
Q

How is ductal carcinoma in situ usually picked up?

A

mammogram screening

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9
Q

What is DCIS

A

Pre-cancerous or cancerous epithelial cells of the breast duct
Localised to a single area

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10
Q

What is LCIS

A

Pre-cancerous condition

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11
Q

How is LCIS usually picked up

A

Incidentally on breast biopsy

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12
Q

How is LCIS managed

A

Close monitorign

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13
Q

How is DCIS managed

A

Excision and adjuvant treatment q

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14
Q

What is invasive ductal carcinoma NST

A

NST no specific type
Originate in cells from breast ducts

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15
Q

Can invasive ductal carcinoma NST be seen on mammograms?

A

Yes

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16
Q

Where do invasive lobular carcinomas originate

A

Lobules

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17
Q

How does inflammatory breast cancer present

A

Swollen
Warm
Tender
Pitting skin

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18
Q

What is Paget’s disease of the nipple

A

Breast cancer involving the nipplE
mAY REPRESENT DCIS OR INVASIVE BREAST CANCER

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19
Q
A
20
Q

How does Paget’s disease of the nipple present

A

Eczema of the nipple
Erythematous scaly rash

21
Q

Explain the breast cancer screening program

A

Mammogram every 3 years aged 50 to 70

22
Q

How often is mammogram offered for those at high risk

A

Annually, age depends

23
Q

What chemoprevention may be offered at women at high risk?

A

Tamoxifen - premenopausal
Anastrozole if post-menopausal

24
Q

What are clinical features that may suggest breast cancer

A

Lump - hard, irregular, painless or fixed in place
Lump tethered to the skin or chest wall
Nipple retraction
Skin dimpling - peau d’orange
Oedema
Lymphadenopathy

25
Q

Who should have a 2 week wait referral?

A

Unexplained breast lump in patients aged 30 or above
Unilateral nipple changes 50 or above

26
Q

What is involved in a triple assessment?

A

Clinical assessment
Imaging
Biopsy

27
Q

Which scan is more effective in older women?

A

mammogram

28
Q

If women are diagnosed with breast cancer, what further investigation are they offered?

A

USS of the axilla and USS guided biopsy of any abnormal nodesW

29
Q

What is a sentinel lymph node biopsy>?

A

Sentinel node biopsy is performed during breast surgery for cancer. An isotope contrast and a blue dye are injected into the tumour area. The contrast and dye travel through the lymphatics to the first lymph node (the sentinel node). The first node in the drainage of the tumour area shows up blue and on the isotope scanner. A biopsy can be performed on this node, and if cancer cells are found, the lymph nodes can be removed.

30
Q

What are the 3 breast cancer receptors

A

Oestrogen receptors
Progesterone receptors
HER2

31
Q

what is triple negative breast cancer

A

Breast cancer cells that do not express any of the three receptors

32
Q

What are the 4 common locations for breast cancer metastasis

A

Lungs
Liver
Bones
Brain

33
Q

What staging system is used for breast cancer

A

TNM

34
Q

What are the treatments for oestrogen receptor positive breast cancer? How long are they given for?

A

Tamoxifen if premenopausal
Aromatase inhibitors for postmenopausal women
5-10 years

35
Q

What is a risk of tamoxifen

A

Increases risk of endometrial cancer

36
Q

How does tamoxifen work

A

Blocks oestrogen receptors in breast tissue

37
Q

How do aromatase inhibitors work

A

Block the creation of oestrogen in fat tissue

38
Q

What targeted treatments can be used for HER2 cancer?

A

Trastuzumab
Pertuzumab
Neratinib

39
Q

What are the main options for breast reconstruction

A

Breast implants
Flap reconstruction

40
Q

wHAT ARE the different types of flap reconstruction?

A
  1. Lattissimus dorsi flap
  2. Transverse rectus abdominis flap
  3. Deep inferior epigastric perforator flap
41
Q

What is the adjuvant hormonal therapy for oestrogen receptor positive cancer in pre menopausal women?

A

Tamoxifen

42
Q

What is the adjuvant hormonal therapy for oestrogen receptor positive cancer in post menopausal women?

A

Anastrozole

43
Q

What are side effects of tamoxifen?

A

Menstrual disturbance
VTE
Increased risk of endometrial ca

44
Q

What is the main side effect of aromatase inhibitors ?

A

Osteoporosis

45
Q

What investigation should women who are starting anastrozole have before ?

A

DEXA scan

46
Q

What adjuvant hormonal therapy is given for those with HER2 receptor positive breast cancer ?

A

Trastuzumab

breast surgery (9 decks)

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