Breast Cancer

Question 1

Lifetime average risk of Breast Cancer?

Answer 1

12-13%

Question 2

Does a first degree relative with postmenopausal breast cancer increase risk?

Answer 2

Very low added risk

Question 3

Does a first degree relative with premenopausal breast cancer increase risk?

Answer 3

Yes! Strong risk factor

Question 4

Risk of breast cancer for BRCA1?

Answer 4

60%
More likely to be triple negative breast cancer

Question 5

Risk of ovarian cancer for BRCA1?

Answer 5

40%

Occurs earlier then BRCA2

Question 6

Risk of breast cancer for BRCA2?

Answer 6

50%
More likely to be hormone receptor positive

Question 7

Risk of ovarian cancer for BRCA2?

Answer 7

20%

Question 8

Aside from breast/ovarian cancer, what other cancer risk is associated with BRCA2?

Answer 8

Prostate
Pancreas
Gastric
Melanoma

Question 9

Two biggest risk factors for breast cancer?

Answer 9

1. Female Sex
2. Advancing age

Others:
Early menarche
Late menopause
Nulliparity
Obesity
Dense breasts
Alcohol consumption
Smoking

Question 10

When should you consider Tamoxifen prophylaxis?

Answer 10

Family hx of pre menopausal breast cancer

> /= 35 yrs with 10 year + life expectancy PLUS one:

• Thoracic radiation < 30
• Locular CIS
• Gale model 5 yr risk >/= 1.7%
• Atypical hyperplasia by breast bx

Question 11

Describe the work up of a palpable breast mass < 30 years old

Answer 11

Ultrasound

If solid mass: tissue biopsy OR US/Dx Mammo/CBE q 6-12 months for 1-2 year to ensure stability

Simple cyst: routine f/up
Complex: Observe, aspirate or biopsy

Question 12

Describe the work up of a palpable breast mass > 30 years old?

Answer 12

Diagnostic Mammogram

Bi-Rad 1-3 = get ultrasound

Bi-Rads 4-5 = Tissue biopsy

Question 13

How much breast cancer is missed with a mammogram?

Answer 13

10%!

Question 14

What is the most common cause of bloody nipple discharge?

Answer 14

Benign intraductal papilloma

Question 15

Most common cause of a solid breast mass?

Answer 15

Fibroadenoma