breast cancer

Question 1

What are the diffferent types of cancer?

Answer 1

1. Carcinoma: lungs, breasts, colon, prostate
2. Leukaemia: bloodstream
3. Lymphoma: lymphnodes
4. Sarcoma: fat, bone, muscle

Question 2

What cells stimulate cell suicide?

Answer 2

tumour suppressor genes

Question 3

What is apoptosis?

Answer 3

cell suicide

Question 4

What is metastasis

Answer 4

cancer cells spread via blood or lymphatic vessels to other sites.

Question 5

What are the causes of breast cancer?

Answer 5

General: viruses and bacteria, chemicals, radiation, diet, hormones INTERACTION WITH heredity

> usually lots of factors combined, with most people we don’t even know the cause; it really depends on your ability to destroy bad cells

Question 6

What are the risk factors for cancer in general?

Answer 6

» Meat consumption - colon cancer
» Cigarette consumption - lung cancer
» Combination of cigarettes and alcohol - cancer of the oesophagus
» Ultraviolet radiation - skin cancer
» Atomic radiation (X-rays) - leukemia
» Viruses and bacteria

Question 7

WHat are the hereditary risk factors of breast cancer?

Answer 7

BRCA1 and BRCA2 gene mutated – Only 1/20 cases due to heredity

The BRCA1 and BRCA2 gene = genes that produce proteins that help repair damaged DNA.
* Chromosome 17, BRCA1 gene (also play a slight role in ovarian cancer)
* Chromosome 13, BRCA2 gene (also play a slight role in pancreas, prostate, melanoma cancer).
* Autosomal dominant

Question 8

What are the controllable risk factors of breast cancer?

Answer 8

not having children or having them late, some types of birth control, not breastfeeding, night work, overweight, etc

Question 9

What are the uncontrollable risk factors of breast cancer?

Answer 9

Gender (more in women), genes, menstruation, ethnicity, age, denser breast tissue, etc.

Question 10

What happens in the case of DNA damage when developing breast cancer?

Answer 10

• One tiny change in a DNA sequence (a single base change) can cause cancer.
• In case of the DNA damage - clearing systems in place (e.g., P53 gene) and ensure apoptosis.
• HOWEVER due to a defect (the risk factors mentioned above) the clearing systems don’t activate.

Question 11

Benign vs. malignant

Answer 11

Benign
* In situ (original position)
* Abnormal growth but doesn’t spread.
* Not life-threatening
* Not cancerous

Malignant
1. Non-invasive – precancerous
* Still in situ
* Close to nearby tissue
2. Invasive – cancerous
* Spreads to other organs

Question 12

What are the different types of breast cancer?

Answer 12

1. DCIS
2. IDC
3. LCIS
4. ILS

Question 13

What are the signs of breast cancer?

Answer 13

» Lump/swelling in chest or armpit.
» Pain in armpits (many lymphnodes swollen)
» Redness of breast
» Rash around nipples
» Area of thickened tissue in skin
» Discharge from nipple, may contain blood.

Question 14

How do we diagnose breast cancer?

Answer 14

» Self–examination
» Imaging tests: ultrasound, MRI, mammography
» Biopsy to confirm whether its benign or malignant.

Question 15

What’s the treatment of breast cancer?

Answer 15

» Surgical removal of cancer in situ or full breast.
» Radiation (only if it’s very invasive)
» Chemotherapy
» Targeted drug therapy= specifically against breast cancer cells
» Hormone therapy against hormone - sensitive cells
* ER – estrogen sensitive.
* PR – progesterone sensitive.

Question 16

Explain the TNM staging system

Answer 16

Based on:
* T = tumor size and spread
* N = spread to lymph nodes
* M = metastasis happened?

Question 17

What are the different stages of (breast) cancer

Answer 17

• STAGE 0: non-invasive
• STAGE1:growth(<2cm), not yet invasive
• STAGE 2A and B: growth + whether or not it’s spread to lymph nodes – from now on cancer.
• STAGE 3A, B and C: growth, spreading further to lymph nodes, skin, and chest.
• STAGE 4: metastasis has happened.

Question 18

…(ratio) vrouwen heeft in de loop van haar leven kanker op de borst

Answer 18

1/8

Question 19

Give some extra details on sarcoma as a type of cancer

Answer 19

metastises quickly
bad prognosis
gets noticed very late

Question 20

explain the role of viruses in breast cancer

Answer 20

They’ll integrate into our cells and DNA, allowing themselves to replicate. They can change DNA, resulting in the production of bad cells
> different viruses for different types of cancer

Question 21

DCIS

Answer 21

non-invasive, stays in the milk ducts, can become invasive

Question 22

IDC

Answer 22

most common breast cancer, wall of lactiferous ducts – causing growth/invasion of surrounding breast tissue – spreads to lymph nodes and then metastases to other organs.
> accounts for 80% of invasive breast cancers!!

Question 23

LCIS

Answer 23

in situ, non-invasive, stays in lobules, can become invasive

Question 24

ILS

Answer 24

10% of breast cancer cases, formed in lobules, invades
nearby tissues via lymphatic vessels and metastases to other organs.

Question 25

ductal carcinoma

Answer 25

in lactiferous ducts

Question 26

lobular carcinoma

Answer 26

in lobules

Question 27

Where’s the first place breast cancer can metastise to

Answer 27

the glands in the armpit area(the sentinel gland) and it’s the first place they check during surgery/examinations/ etc.

Question 28

lifetime risks brca1/2 associated cancers

Answer 28

breast cancer: 50-70%
secondary breast cancer (or stage IV breast cancer): 40-50%
ovarian cancer: 15-55% (BRCA 1> BRCA 2)

Question 29

BRCA 1 and BRCA 2 related risks of other cancers
- male breast cancer
- pancreatic cancer
- prostate cancer
- melanoma

Answer 29

1. BRCA 2> BRCA 1
2. BRCA 2
3. BRCA 2
4. BRCA 2

Question 30

incidence of breast cancer by race

Answer 30

caucasian > african > asians > hispanic > native american

Question 31

survival rates breast cancer vs. stages

Answer 31

Stage 0: 100%
Stage 1: 100%
Stage 2: 93%
Stage 3: 72%
Stage 4: 22%