Breast Cancer Flashcards
How does breast cancer rank in cancer frequency and cancer death?
1st in frequency for females second in death
What fraction of women in the US will get breast cancer?
1/8
What breast cells give rise to the most breast cancer?
lobules and ducts
What is the main blood supply of the breast?
internal mammary (60%)
What is the primary site of lymph drainage?
axilla
What are the 3 anatomical levels of lymph, in reference to pec minor?
1- lateral
2- deep
3- medial
What are risks of breast cancer?
sex age personal hx with BRCA Fhx breast changes gene changes reproductive and menstrual hx race xrt to chest wall DES exposure breast density postmenopausal obesity lack of physical activity EtOH consumption
What is the GAIL MODEL
used to determine the risk of BRCA; develops lifetime risk factors
does pt have hx of BRCA or DCIS/LCIS? age? age at menarche? age at 1st child birth? how many 1st deg relatives have had BRCA? has pt had breast biopsy? if so how many? atypical hyperplasia found? ehtnicity?
What does GAIL MODEL calculate?
the 5 yr and life long risk of developing BRCA
What is considered high risk for the GAIL MODEL?
> 1.6%
The role of _________ could get a ________ % permanent reduction in lifetime risk
hormonal chemoprevention, 50
What types of breast cancer screenings are there?
self breast exam clinical breast exam screening mammogram US MRI
How often should you preform a self breast exam?
monthly
How much have self breast exams affected the reduction of BRCA deaths?
none
How often should you have a clinical breast exam?
every year
How often should you have a screening mammogram?
every 1-2 years, at 50 every year
Why would you have a breast US?
if you suspect a cystic lesion or the pt is very young; they have denser breast tissue
Why are mammograms not the best for younger females?
they have denser breast tissue and it may not be beneficial
When would you have an MRI to look at your breasts?
if you have BRCA 1&2
1st degree relative with BRCA
GAIL risk of >25%
RXT to chest
What is the most common initial mammogram presentation for women with BRCA?
abnormal
What percentage of mammograms have abnormal results?
5-10%
What is BRAIDS?
breast imaging and reporting data system
What are the BRAIDS categories?
0- incomplete 1- negative finding 2- benign finding 3- probably benign finding, 6 mo follow up 4- suspicious abnormality 5- highly suggestive of malignancy 6- known biopsy proven malignancy
Why do we use BRAIDS?
used to standardize breast cancer reporting