breast cancer Flashcards
What is BRCA1?
human tumor suppressor gene, located on long arm of chrom 17, mutated it means 80% risk of cancer by age 90
ER?
Estrogen receptor, in 70% of bc cases
PR?
Progesterone receptor
HER2?
Human epidermal growth factor 2
2 breast cancer drugs?
tamoxifen and herceptin
tamoxifen?
blocks estrogen receptors
herceptin?
monoclonal ab interfers with HER2 receptor
how many people developed breast cancer in 2009?
according to NICE, 39,972 people developed, 291 men
what are lifestyle links between bc?
diet and smoking inc risk 35-50%
how much does the government spend over next 4 years and on what?
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
how much on early diagnosis?
450 mil
name 2 biopsies
stereotactic core biopsy and ultrasound guided biopsy
survival rates?
98% pre lymph node spread, 84% after spread to lymph and 20% when spread to vital org
give 4 screening criteria for the condition
condition must be important health prob, there must be detectable factors, primary prevention interventions must have been implemented and mutations must be understood
give 5 screening critiera for the test
simple/safe/precise/validated test, defined cut off levels, acceptable to population, pathways agreed upon, mutation subset criteria
give 5 screening criteria for treatment
effective treatment with early intervention, agreed upon criteria for which individuals offered, management of condition optimised, benefits outweigh costs, economically balanced
who is a mammogram done by?
female health pro
how many mammogram scans taken?
2 x rays per boob, above and to the side
what is done to the boob?
squashed between 2 small flat plates for a few seconds then x rayed
what does the mammogram use?
low energy x rays, around 30kVp to examine boob
what are mammogram limitation
doesnt work as well in women under 50 because less fat in the boob
give 4 risks of mammogram
radiation, pain, false positives, over diagnosis
what is over diagnosis?
detecting and subsequently treating non-threatening cancers/tumors
what did Gotzsche and Nielsen say?
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
give a quotey reference for over diagnosis
Gotzsche and Nielsen in 2011 said the rate of over diagnosis is 9.8/2000 women screened
give a quotey reference for false pos
Gotzsche and Nielsen in 2011 said for every 2000 women screened over 10 years, 200 will experience psychological stress due to a false pos
what did the Advisory committee on Breast cancer screening estimate?
for every 400 women screened regularly over 10 year period, 1 woman fewer will die
give a quotey reference on the change in women death
the advisory committee on breast cancer screening estimated that for every 400 women screened regularly over 10 year period, 1 woman fewer will die
what is screening estimated to do in 50-59 yr olds?
cut mortality by 25%
