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Reproduction > Breast cancer 2 > Flashcards

Breast cancer 2 Flashcards

1
Q

What age of women are invited for screening?

A

50-70

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2
Q

How often are women aged 50-70 invited for screening for breast cancer?

A

Every 3 years

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3
Q

How long a wait is urgent referral for breast cancer?

A

2 weeks

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4
Q

What are indications for urgent referral for breast cancer?

A
  • They are >30 with an unexplained breast mass

* They are >50 or older presenting with nipple discharge, retraction or other concerning symptoms.

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5
Q

When should you consider referral for screening?

A

30 years or older with an unexplained mass in the axilla

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6
Q

When would you non-urgently refer someone for breast cancer screening?

A

Patients under 30 years old with an unexplained breast mass.

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7
Q

When would someone with familial breast cancer not need to be referred?

A

Only have one first-degree or second-degree relative diagnosed with breast cancer

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8
Q

What are the indications for someone with familial breast cancer to be referred?

A
  • age of diagnosis < 40 years
  • bilateral breast cancer
  • male breast cancer
  • ovarian cancer
  • Jewish ancestry
  • sarcoma in a relative younger than age 45 years
  • glioma or childhood adrenal cortical carcinomas
  • complicated patterns of multiple cancers at a young age
  • paternal history of breast cancer (two or more relatives on the father’s side of the family)
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9
Q

What genes increase the risk of breast cancer?

A

BRCA1, BRCA2 genes

P53 gene

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10
Q

What are possible risk factors for developing breast cancer?

A
  • nulliparity, 1st pregnancy > 30 yrs
  • early menarche, late menopause
  • combined hormone replacement therapy, combined oral contraceptive use
  • past breast cancer
  • not breastfeeding
  • ionising radiation
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11
Q

What type of cancers is BRCA 1 more likely to give rise to?

A

High grade triple negative cancers.

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12
Q

What type of cancers is BRCA 2 more likely to give rise to?

A

Oestrogen and progesterone receptor positive tumours.

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13
Q

What are all breast cancer pathologies tested for?

A

Hormonal receptor activity

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14
Q

What hormonal receptors are breast pathologies checked for?

A

Oestrogen (ER)
Progesterone (PR)
HER2 (human epidermal growth factor receptor type 2)

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15
Q

What is the management of ER positive tumours if premenopausal?

A

Tamoxifen (oestrogen receptor antagonist) if premenopausal

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16
Q

What is the management of ER positive tumours if post menopausal?

A

Anastrozole (aromatase inhibitor) if postmenopausal.

17
Q

What is the management of HER2 positive tumours?

A

Receive Trastuzumab (otherwise known as Herceptin) which is a monoclonal antibody against the extracellular domain of the HER2 receptor

18
Q

What are the components of triple assessment?

A

Clinical examination
Radiological examination
Biopsy

19
Q

What does the clinical examination involve?

A

Examination of the breast and surrounding lymph nodes

20
Q

What does the radiological examination involve?

A

Mammography mainly

Can also involve breast ultrasound and MRI scanning

21
Q

What does the biopsy involve?

A

Core Needle Biopsy or Fine Needle Aspirate

22
Q

What are the 2 forms of surgical management for breast cancer?

A

Wide local excision (WLE)

Mastectomy

23
Q

What is WLE usually used for?

A

Smaller, solitary lesions which are peripherally located

24
Q

What are sentinal node biopsies preformed for?

A

All invasive cancers

25
Q

When might Axillary node clearance be necessary?

A

If there are positive nodes

26
Q

When is Radiotherapy offered?

A

Almost all patients with Wide Local Excision should be offered adjuvant radiotherapy – reduces recurrence

27
Q

What can be given for Her2 positive patients?

A

Biological therapy

Trastuzumab (Herceptin) can be given to HER2 positive patients.

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