Breast Cancer

Question 1

how does breast cancer present

Answer 1

lumps/bumps

skin changes

dimpling/nipple inversion

red, hot

+/- pain

regional node enlargement

Question 2

which is associated with cancer? breast pain or no breast pain?

Answer 2

no breast pain (usually)

Question 3

what is the gold standard to diagnose breast cancer?

Answer 3

bx or aspiration

Question 4

what are the 2 types of non-invasive breast cancer?

Answer 4

ductal CIS lobular CIS

Question 5

what is the most common type of breast cancer?

Answer 5

DCIS

Question 6

where does DCIS begin?

Answer 6

in the milk ducts

Question 7

what are the s/s of DCIS?

Answer 7

none

Question 8

is DCIS really bad?

Answer 8

it’s not life-threatening but can increase your risk of getting a worse cancer

Question 9

how do you treat non-invasive cancers?

Answer 9

lumpectomy +/- rad

Question 10

what are the 2 types of invasive breast cancers?

Answer 10

invasive lobar carcinoma

invasive ductal carcinoma

Question 11

where does invasive lobar carcinoma start?

Answer 11

milk-producing lobules

Question 12

at what age do people get invasive lobar carcinoma?

Answer 12

60s

Question 13

what type of invasive carcinoma is the most common?

Answer 13

invasive ductal carcinoma

Question 14

which type of breast cancer is most common in men?

Answer 14

invasive ductal carcinoma

Question 15

is fibrocystic disease a type of breast cancer?

Answer 15

no but puts you at at 2x risk

Question 16

what are the 2 types of cancer that fibrocystic disease can lead to?

Answer 16

indraductal papilloma

ductal hyperplasia

Question 17

what is the main sx of intraductal papilloma?

Answer 17

bloody nipple discharge

Question 18

what happens physiologically in ductal hyperplasia?

Answer 18

increase in the epithelial layers of the ducts

Question 19

which type of breast cancer is rare and is known as a phyllodes tumor?

Answer 19

stromal tumor

Question 20

what determines breast cancer staging?

Answer 20

size

spread to lymph nodes + how many

spread to other parts of the body

Question 21

how do you treat local breast cancer?

Answer 21

surgery

post-surg radiation

Question 22

what are the 3 surgical options for local breast cancer?

Answer 22

lumpectomy

mastectomy

lymph node bx or dissection

Question 23

how do you treat systemic breast cancer?

Answer 23

chemo

HT

estrogen receptor down-regulators (ERDs)

ovarian shut-down

HER2 therapies

Question 24

what is an example of an ERD

Answer 24

tamoxifen

Question 25

when do you follow up after treating breast cancer?

Answer 25

every 3-6 months for 3y every 6-12 months for years 4-5 every year after that

Question 26

what type of breast cancer is rare but very invasive?

Answer 26

inflammatory breast cancer

Question 27

when do people get inflammatory breast cancer?

Answer 27

in their 50s

Question 28

how do you diagnose inflammatory breast cancer?

Answer 28

skin punch bx

Question 29

what tests do you give to determine breast cancer staging?

Answer 29

CXR CT chest, abdomen, pelvis bone scan LFTs

Question 30

the treatment for inflammatory breast cancer is AGGRESSIVE. what is it?

Answer 30

chemo prior to surgery radical mastectomy hormone tx

Question 31

sooo a long time ago we talked about lobular CIS, so what exactly is LCIS

Answer 31

a collection of abnormal cells in the breast that increases cancer risk it is HER2 +

Question 32

when is LCIS diagnosed?

Answer 32

before menopause, usually when bx is done for another reason

Question 33

what is the rare disease that involves cancer cells in/around the nipple?

Answer 33

Paget's disease of the nipple

Question 34

what do people with paget's disease of the nipple usually have as a co-morbid condition?

Answer 34

DCIS or an invasive breast cancer elsewhere

Question 35

what are s/s of Paget's disease of the nipple?

Answer 35

itching, burning, tingling, pain/sensitivity, thick skin, scaly, yellow/bloody discharge from the nipple