Breast cancer Flashcards
What is the MC site of lumps?
upper outer quadrant including tail of spence
What node is found in the axillary?
sentinel node (first node that cancer spreads to)
What are some suspicious signs of breast cancer?
Dimpling (peau d’orange)
depression
deviation (asymmetrical)
discolouration
discharge
nipple eczema persisting with Tx
mets Sx (bone pain/pleural effusion)
What age does the NHS breast screening range from? How often and what test is done?
47-73 years old
3 yearly mammograms
what is the % decrease in mortality of Breast ca with this screening?
16-29%
Which 2 conditions mean that breast cancer is high risk?
BRCA gene carriers
li fraumeni
How often are BRCA gene carriers screened and what ages?
annually
25-60
How often are Li Fraumeni syndrome Px screened and what ages?
20-70
annually
What type of gene is BRCA?
what are the types?
autosomal dominant
BRCA 1 + 2
BRCA 1
what autosome is it on?
associated with?
What can ppl that have BRCA 1 get as prophylaxis and get for free?
C17
Assoc with inherited Breast Ca
Can have prophylactic mastectomy or tamoxifen
Can select embryos that aren’t BRCA +ve
BRCA 2
what autosome is it on?
associated with?
Increased risk of?
C13
Associated with male breast cancer
increased risk of ovarian and pancreatic Ca
What is the triple assessment?
- Hx and exam
- imaging (Mammogram/X RAY, USS, MRI)
- Cytology (biopsy)
Mammogram/X RAY
what would the cancer look like?
CI in who?
what age are mammograms used on and why?
Ca = hyperdense (white)
>40
CI in <40 - cannot pick up Ca in. younger dense breast or female with high HRT
USS
What would cancer look like?
Used in what age and why?
Ca = hypodense (dark)
<40 - young dense breast
MRI
Pros and cons
pros - good for implants, identifying ruptures, safe and reliable
Cons - expensive + claustrophobic
What are the 2 cytology tests done?
fine needle biopsy (FNAC)
core biopsy
Pros and cons of fine needle biopsy
Pros:
Less invasive
detects cancer
Cons:
No receptor status
No in situ vs invasive
Pros and cons of core biopsy
Pro:
diagnoses Ca
receptor status
in situ vs invasive
Cons:
very invasive and painful
what is the lifetime risk of breast cancer in UK?
median age?
1/8
62
RF for breast CA?
Nulliparous
Early menarche/late menopause
obesity
smoking
Alcohol (1.3 RR)
HRT (5+ Y)
Conditions increasing risk of breast Ca?
BRCA
Li Fraumeni
Peutz Jeghers
What is Li Fraumeni?
increases risk of developing?
TP53 mutation
increases risk of developing brain, breast Ca, leukaemia and lymphoma
what is protective of breast Ca?
exercise
What family Hx can increase Risk of breast Ca?
affected 1^ F<50y bilaterally or <40y unilateral + any 1^ affected M
