Breast Cancer Flashcards

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1
Q

Describe the aetiology of breast cancer

A

It’s most common in early post menopausal women
Early menarche menstruation and late menopause - due to menstruation history of hormone exposure
Nulliparity - no children so no break from menstruation
Late pregnancy - hormone surges

Breast feeding however offsets the risks of breast cancer

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2
Q

How do genetic effect the ricks of breast cancer ?

A

Family history - carriers of the BRAC1 and BRAC2
Previous breast disease - cysts and abscesses
Alcohol and high fat consumption
HRT linked to longer time with high hormone levels

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3
Q

80% of breastfeeding cancers occur in what region ?

A

Ductal region of the breast

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4
Q

What is a ductal carcinoma ?

A

This is an early form of breast cancer which can be non-invasive but affects the whole ductal region. When not treated this can lead to cancer cell division along the whole of the ducts

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5
Q

What hormone has the most impact on the potential of breast cancers ?

A

Oestrogen

Oestrogen metabolites can build up in certain circumstances and initiate cellular changes in the breast
The properties of the hormone oestrogen can initiate the proliferation of cancer

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6
Q

What are the two oestrogen receptors ?

A

ERB (Alpha)
And
ERB (Beta)

These receptors are found in a range of tissues in the breast ovaries and endothelium

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7
Q

What happens to cells when oestrogen enters ?

A

They bind with oestrogen receptors and migrates into the nucleus. This leads to transcription proteins that indicate change within the cells
Because oestrogen has proliferation properties, it can have negative effects on patients that have large quantities of these receptors intracellularly

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8
Q

What is hyperplasia ?

A

An increase in the growth of normal cells within the tissues, causing organ growth

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9
Q

What is dysplasia ?

A

The increase of abnormal cell growth in a tissue - precancerous state

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10
Q

What is metaplasia ?

A

When one mature cell type is replaces by another mature cell type that is not indigenous to that region of tissue where it is found
Is benign and noncancerous, can become dysplasic if not treated

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11
Q

What is neoplasia ?

A

Abnormal growth of cells, known to cause tumour growths, can be benign or malignant

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12
Q

What is Pleo-morphism ?

A

The ability for some microorganisms to alter their shape or size in response to environmental conditions

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13
Q

What is metastasis ?

A

When cancer cells migrate from one part of the body to another, cancer cells where the cancer metastatic cancer hasn’t originated from

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14
Q

What are the two main drug pharmacodynamics of breast cancer drugs ?

A

To reduce the uptake of oestrogen at oestrogen receptors: SERM’s + ERD’s
Or
Reduce production of circulating oestrogen: LGRH’s + Aromatase inhibitors

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15
Q

What is the mode of action and side effects for SERM’s

A

MOA - is an oestrogen antagonist (anti-oestrogen) which competes with oestrogen receptors at the binding site in target tissues
Binds to oestrogen receptors to inhibit the uptake of oestrogen in the hippocampus

Blocks intake of oestrogen, reducing proliferation effects on breast tissue and can prevent oestrogen positive tumour growth

SE - hot flushes, fatigue, joint pain

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16
Q

What is the mode of action and side effects of ERD’s ?

A

MOA - Binds to the oestrogen receptors in cancer cells to block the uptake of oestrogen and reduce the impact on breast tissue. Degrades the oestrogen receptors.

Side effects - reaction to injection site
Nausea
Vomiting

17
Q

What are the mode of action and side effects of LHRH’s

A

MOA - binds to Gonadotrophin releasing hormone (GnRH) receptors which decreases production of Gonadotrophin in the medulla
By blocking this action, less oestrogen will be produced

Side effects - decreased appetite
Joint pain
Headache
Depression

18
Q

What is the mode of action and side effects of Aromatase inhibitors

A

MOA - inhibits action of the enzyme Aromatase which overs androgens into oestrogen - known as ‘aromatisation’
By blocking this enzyme, less oestrogen will be produced

Side effects - joint and muscle pain
Hot flushes

19
Q

What are the signs and symptoms of breast cancer ?

A

Feeling or seeing a lump
Discharge/blood from nipple
Swelling of the axilla
Size/shape/colour difference of breast

20
Q

Triple asssesment done by clinical assessment involves what two investigations ?

A

Imaging
And
Needle aspiration

These are most accurate

21
Q

What is palpation ?

A

This is when an individual or clinical specialist feels the breast and surrounding areas for any abnormalities that could be a tell for breast carcinomas

22
Q

What age is a mammography likely to be done for ?

A

Can show cancerous changes but better results in over 50 year olds

23
Q

When is an ultrasound most useful ?

A

When the metastatic spread to the axilla

24
Q

Why are blood tests taken when screening ?

A

For the patients genetic profile and to see if there are BRAC1 and 11