Breast cancer 2 Flashcards
What age of women are invited for screening?
50-70
How often are women aged 50-70 invited for screening for breast cancer?
Every 3 years
How long a wait is urgent referral for breast cancer?
2 weeks
What are indications for urgent referral for breast cancer?
- They are >30 with an unexplained breast mass
* They are >50 or older presenting with nipple discharge, retraction or other concerning symptoms.
When should you consider referral for screening?
30 years or older with an unexplained mass in the axilla
When would you non-urgently refer someone for breast cancer screening?
Patients under 30 years old with an unexplained breast mass.
When would someone with familial breast cancer not need to be referred?
Only have one first-degree or second-degree relative diagnosed with breast cancer
What are the indications for someone with familial breast cancer to be referred?
- 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)
What genes increase the risk of breast cancer?
BRCA1, BRCA2 genes
P53 gene
What are possible risk factors for developing breast cancer?
- nulliparity, 1st pregnancy > 30 yrs
- early menarche, late menopause
- combined hormone replacement therapy, combined oral contraceptive use
- past breast cancer
- not breastfeeding
- ionising radiation
What type of cancers is BRCA 1 more likely to give rise to?
High grade triple negative cancers.
What type of cancers is BRCA 2 more likely to give rise to?
Oestrogen and progesterone receptor positive tumours.
What are all breast cancer pathologies tested for?
Hormonal receptor activity
What hormonal receptors are breast pathologies checked for?
Oestrogen (ER)
Progesterone (PR)
HER2 (human epidermal growth factor receptor type 2)
What is the management of ER positive tumours if premenopausal?
Tamoxifen (oestrogen receptor antagonist) if premenopausal
What is the management of ER positive tumours if post menopausal?
Anastrozole (aromatase inhibitor) if postmenopausal.
What is the management of HER2 positive tumours?
Receive Trastuzumab (otherwise known as Herceptin) which is a monoclonal antibody against the extracellular domain of the HER2 receptor
What are the components of triple assessment?
Clinical examination
Radiological examination
Biopsy
What does the clinical examination involve?
Examination of the breast and surrounding lymph nodes
What does the radiological examination involve?
Mammography mainly
Can also involve breast ultrasound and MRI scanning
What does the biopsy involve?
Core Needle Biopsy or Fine Needle Aspirate
What are the 2 forms of surgical management for breast cancer?
Wide local excision (WLE)
Mastectomy
What is WLE usually used for?
Smaller, solitary lesions which are peripherally located
What are sentinal node biopsies preformed for?
All invasive cancers
