Breast cancer

Question 1

Breast cancer is the ______ common in women

Answer 1

most common cancer in women (aprox 1 in 9)

rarely seen in men

Question 2

etiology and risks

Answer 2

• familial (first degree relatives at higher risk)
• 5-10% is inheritied:-BRCA1 gene on CHR17 _BRCA2 gene on CHR13
• ageing (cumulative exposure to carcinogens)
• hormone factors: -hormone replacement therapy (estrogen & progesterone for menopausal women experiencing serious side effects)
• late menopause & early menarche(first menstruation) (have estrogen & experience estrogen for longer)
• nulliparity (not having any offspring) (if menstruation cycle not broken by pregnancy at higher risk for reproductive cancers)

Question 3

several forms of breast cancer

Answer 3

• ductal carcinoma in situ: characterised by proliferation of malignant cells inside milk ducts without invasion
• infiltrating ductal carcinoma:(80% of cases) most common histologic breast cancer, tumour arises from duct systems & invade surrounding tissue
• infiltrating lobular carcinoma:(10-15% of breast cancers) tumors arise from lobular epithelium
• medullary carcinoma(5%)
• colliod carcinoma (rare): cancer cells are mucus producing & have better prognosis & lower chance of metastasis
• tubular carcinoma (2%)
• inflammatory carcinoma (inflammatory breast cancer)(1-3%)

Question 4

what is the gene that could put you at risk for breast cancer

Answer 4

BRCA1 gene on CHR17

BRCA2 gene on CHR13

Question 5

where is the prevalence of breast cancer most highest?

Answer 5

upper outer quadrant, closer to axillary region, armpit (48%)

Question 6

Dutcal carcinoma in situ

Answer 6

• approx 20%
• tumor is restrictive & localized
• intraductal(from ductal epithelium):
  - non invasive(wont move from duct hence “in situ”)
  - good prognosis(good to have a non invasive cancer)
• stage 0: not referring to TNM stage, some cancers stage 0-4. refers to early stage of breast cancer sometimes precancerous is used. this form if not dealt with will progress to move aggressive form, this is also why referred to as precancerous

Question 7

what does the in situ refer to in ductal carcinoma in situ?

Answer 7

in situation, in original location. here means malignancy is localized not spread

Question 8

what can happen if ductal carcinoma is not dealt with?

Answer 8

without ductal carcinoma in situ will lead to infiltrating ductal carcinoma, can also happen right away without starting as ductal carcinoma in situ

Question 9

infiltrating ductal carcinoma

Answer 9

• most common (approx 75%)
• ductal origin
• solid, irregular mass (usually detected by women herself)
• invasive: enters lymphatics then move to axillary lymph nodes (proximal metastasis)
• proximal mets to axillary lymph nodes
• distal mets (eg. liver & brain-life threatening, bone-not life threatening)

Question 10

mnfts of breast cancer

Answer 10

• painless mass: usually upper outer quadrant

- late mnfts: discharge, retraction & edema of nipple (generally intervention will happen before these mnfts)

Question 11

diagnosing lung cancer

Answer 11

-mammography (both screen & diagnostic test)(controversial to use for screenings, false positives,false negatives,extreme interventions after-mastectomy)