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w221 Gynae + breast Cancer > breast cancer > Flashcards

breast cancer Flashcards

1
Q

What does ER receptor positive mean?

A
  • It describes whether or not the breast cancer has oestrogen receptors.
  • Further to this, if the Ca. is ER +ve then the cancer cells grow in response to the hormone estrogen
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2
Q

What % of breast cancers are ER +ve?

A

About 70% of breast cancers are ER positive

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3
Q

What does HER2 positive mean?

A

It means that the breast cancer has high numbers of receptors for the protein HER2 (human epidermal growth factor 2)

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4
Q

What is used to treat HER2 cancers?

A

Herceptin → trastuzumab

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5
Q

What is a triple negative breast cancer?

A

Breast cancer that has no receptors fo HER2, oestrogen and progesterone.

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6
Q

What is tamoxifen?

A
  • Tamoxifen is a Selective oEstrogen-Receptor Modulator (SERM)
  • It is used to treat ER +ve Breast cancer
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7
Q

What are the side effects of Tamoxifen?

A
  • Increased risk of uterine cancer → Endometrial cancer
  • Stroke
  • Vision problems
  • Pulmonary embolism
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8
Q

What does tamoxifen do?

A

It is an Oestrogen receptor antagonist for breast tissue.

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9
Q

What is it important to remember about HER2 recpetor breast cancers?

A

They are aggressive and fast growing.

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10
Q

What Gene are triple negative breast cancers associated with?

A

BRCA1

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11
Q

What do the BRCA1 and BRCA2 genes do?

A

They maintain healthy breast cells → they help repair damaged DNA, or destroy cells if DNA cannot be repaired

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12
Q

What are mutations in BRCA1 associated with?

A
  • Breast and Ovarian are the big 2
  • Also associated with:

→ Prostate

→ colon

→ pancreas

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13
Q

What are mutations in BRCA2 associated with?

A
  • Breast and Ovarian are the big 2
  • Also associated with:

→ Prostate

→ colon

→ pancreas

→ stomach

→ melanoma

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14
Q

What does DCIS stand for?

A

Ductal carcinoma in situ

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15
Q

What does LCIS stand for?

A

Lobular carcinoma in situ

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16
Q

What is sometimes seen as cacification on mamograms?

A

DCIS

17
Q

What are signs and symptoms of early breast cancer?

A
  • Change in breast size or shape
  • Skin dimpling or skin changes
  • Recent nipple inversion or skin change, or nipple abnormalities
  • Single-duct discharge, particularly if blood-stained
  • Axillary lump
18
Q

What are some risk factors associated with breast cancer?

A

Risk is primarily associated with family Hx, Age and uninterupted oestrogen exposure →

  • Nullparity
  • 1st pregnancy >30yrs old/ not breastfeeding
  • early menarche/ late menopause
  • HRT
  • Obesity
  • BRCA gene mutations/ past Breast cancer
19
Q

What is the triple investigation for breast cancer?`

A

Clinical examination + histology/cytology + Mammography/ultrasound

20
Q

What is the most common breast cancer?

A

Invasive ductal carcinoma (~70%)

21
Q

What is the 2nd most common form of breast cancer?

A

Invasive lobular carcinoma (~10-15%)

22
Q

Which breast cancer is associated with younger people?

A

Medullary carcinomas

23
Q

What is sentinel node biopsy?

A
  • Patent blue dye or radioactive colloid are injected into the tumour.
  • The node that takes up the dye is the sentinel node.
  • This is biopsied to assess nodal involvement.
24
Q

Why is nodal involvement so important in breast cancer?

A

because it signifies a dramatic drop in predicted survival rates.

25
Q

Which index is used to assess prognostic survival and relapse rates?

A

• Nottingham Prognostic Index (NPI) → 0.2 x tumour size x histological grade + nodal status

26
Q

Name 3 benign breast diseases that can cause a lump?

A
  • Fibroadenoma
  • Breast cyst
  • Infective mastitis/breast cyst
  • Duct ectasia
  • Fat necrosis
27
Q

What is a Fibroadenoma?

A
  • Common in women <30yrs
  • Firm, smooth, mobile, painless lump.
  • A benign overgrowth of collagenous mesenchyme of one breast lobule
  • USS usually conclusive
  • Often described as ‘breast mice’ due as they are discrete, non-tender, highly mobile lumps
28
Q

What is a breast cyst?

A
  • Common in women > 35yrs esp. perimenopausal
  • Non-fixed, fluid-filled rounded lump.
  • Benign occasionally painful.
  • Confirmed on aspiration
29
Q

What is an infective mastitis?

A
  • Infection of a mamary duct → often associated with lactation/breastfeeding.
  • Usually caused by S.Aureus
  • Antibiotics +/- open inscision or percutaneous drainage if abcess.
30
Q

What is duct ectasia?

A
  • From the greek meaning → dilation or distention of a tubular structure
  • Typically around menopause, ducts become blocked and secretions stagnate
  • Presents with nipple discharge +/-nipple retraction +/- Lump
  • Refer
31
Q

What is fat necrosis?

A
  • Fibrosis and calcification following injury to breast tissue
  • Scarring results in firm lump
  • Refer for triple investigation
  • More common in obese women with large breasts
32
Q

What pathology would a hard, irregular lump with possible associated nipple inversion or skin tethering imply

A

Breast cancer

w221 Gynae + breast Cancer (2 decks)

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