breast cancer

Question 1

What is BRCA1?

Answer 1

human tumor suppressor gene, located on long arm of chrom 17, mutated it means 80% risk of cancer by age 90

Question 2

ER?

Answer 2

Estrogen receptor, in 70% of bc cases

Question 3

PR?

Answer 3

Progesterone receptor

Question 4

HER2?

Answer 4

Human epidermal growth factor 2

Question 5

2 breast cancer drugs?

Answer 5

tamoxifen and herceptin

Question 6

tamoxifen?

Answer 6

blocks estrogen receptors

Question 7

herceptin?

Answer 7

monoclonal ab interfers with HER2 receptor

Question 8

how many people developed breast cancer in 2009?

Answer 8

according to NICE, 39,972 people developed, 291 men

Question 9

what are lifestyle links between bc?

Answer 9

diet and smoking inc risk 35-50%

Question 10

how much does the government spend over next 4 years and on what?

Answer 10

750 million, promoting lifestyle changes to increase risk of preventable cancers, increase uptake of screening, expanding screening programmes, increase early diagnosis and 450 mil of it on early diagnosis

Question 11

how much on early diagnosis?

Answer 11

450 mil

Question 12

name 2 biopsies

Answer 12

stereotactic core biopsy and ultrasound guided biopsy

Question 13

survival rates?

Answer 13

98% pre lymph node spread, 84% after spread to lymph and 20% when spread to vital org

Question 14

give 4 screening criteria for the condition

Answer 14

condition must be important health prob, there must be detectable factors, primary prevention interventions must have been implemented and mutations must be understood

Question 15

give 5 screening critiera for the test

Answer 15

simple/safe/precise/validated test, defined cut off levels, acceptable to population, pathways agreed upon, mutation subset criteria

Question 16

give 5 screening criteria for treatment

Answer 16

effective treatment with early intervention, agreed upon criteria for which individuals offered, management of condition optimised, benefits outweigh costs, economically balanced

Question 17

who is a mammogram done by?

Answer 17

female health pro

Question 18

how many mammogram scans taken?

Answer 18

2 x rays per boob, above and to the side

Question 19

what is done to the boob?

Answer 19

squashed between 2 small flat plates for a few seconds then x rayed

Question 20

what does the mammogram use?

Answer 20

low energy x rays, around 30kVp to examine boob

Question 21

what are mammogram limitation

Answer 21

doesnt work as well in women under 50 because less fat in the boob

Question 22

give 4 risks of mammogram

Answer 22

radiation, pain, false positives, over diagnosis

Question 23

what is over diagnosis?

Answer 23

detecting and subsequently treating non-threatening cancers/tumors

Question 24

what did Gotzsche and Nielsen say?

Answer 24

the rate of over diagnosed breast cancer is 9.8/2000 women screened, and for every 2000 women screened over 10 years, 200 will experience psychological stress due to a false pos

Question 25

give a quotey reference for over diagnosis

Answer 25

Gotzsche and Nielsen in 2011 said the rate of over diagnosis is 9.8/2000 women screened

Question 26

give a quotey reference for false pos

Answer 26

Gotzsche and Nielsen in 2011 said for every 2000 women screened over 10 years, 200 will experience psychological stress due to a false pos

Question 27

what did the Advisory committee on Breast cancer screening estimate?

Answer 27

for every 400 women screened regularly over 10 year period, 1 woman fewer will die

Question 28

give a quotey reference on the change in women death

Answer 28

the advisory committee on breast cancer screening estimated that for every 400 women screened regularly over 10 year period, 1 woman fewer will die

Question 29

what is screening estimated to do in 50-59 yr olds?

Answer 29

cut mortality by 25%