Breast Cancer Flashcards

1
Q

def of breast cancer in situ

A

breast cancer confined to the duct or lobule

does not extend beyond the basement membrane

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2
Q

what is ductal carcinoma in situ

A

precursor to invasive carcinoma

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3
Q

what are the different types of breast cancer in situ

A

DCIS

LCIS

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4
Q

what does DCIS increase risk of

A

invasive breast cancer at site of biopsy

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5
Q

what does LCIS increase risk of

A

invasive breast cancer in either breast

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6
Q

which was more common DCIS or LCIS

A

DCIS (85%)

LCIS (15%)

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7
Q

epi

A

elderly

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8
Q

what does HRT increase risk of

A

invasive breast cancer

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9
Q

what does HRT not have an affect on

A

DCIS

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10
Q

aetiology of DCIS

A

proliferation of malignant appearing epithelial cells which have not penetrated the basement membrane

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11
Q

where is the origin of most DCIS

A

terminal duct lobular lesions

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12
Q

what is the progression of benign disease to invasive breast cancer

A

1 typical hyperplasia
2 atypical hyperplasia
3 DCIS
4 invasive breast cancer

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13
Q

what receptor is associated with DCIS

A

oestrogen receptor

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14
Q

what marker is used to guide therapy with DCIS

A

HER2

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15
Q

is HER2 more highly expressed in DCIS or invasive breast cancer

A

DCIS

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16
Q

how does oestrogen play a role in breast cancer in situ

A

higher oestrogen levels (women) stimulate proliferation of breast epithelial cells in lobules and ducts
mutations occur in these epithelial cells

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17
Q

what should be given to women who are at high risk of breast cancer

A

SERM (selective oesotrogen receptor modulator) such as tamoxifen

18
Q

risk factors for breast cancer

A
FHx of breast or ovarian cancer
klinefelters syndrome
older age at menopause
older age at first pregnancy
nulliparity
19
Q

what is peutz jeghers syndrome

A

predisposition to stomach, colon, pancreas, thyroid, breast, lung cancers

20
Q

features of breast cancer in situ

A
RFs and FHx of breast cancer
nipple discharge (indicating papilloma most commonly or less commonly DCIS
21
Q

first line investigation for breast cancer in situ

A

mammography looking for calcifications

22
Q

def of primary invasive breast cancer

A

breast malignancy which has spread past the basement membrane into surrounding tissues

23
Q

epi

A

most common female malignancy

elderly

24
Q

aetiology of invasive breast cancers

A

1 genetic factors
-BRCA mutation
2 hormonal factors
-increased levels of oestrogen

25
Q

what does BRCA mutation increase risk of

A

breast and ovarian cancer

breast>ovarian

26
Q

what are different types of epithelial tumours

A

invasive ductal carcinoma
invasive lobular carcinoma
tubular carcinoma
medullary carcinoma

27
Q

what is a tumour of the nipple

A

pagets disease of the nipple

28
Q

what is the primary prevention for breast cancer

A

SERM such as tamoxifen

29
Q

how often does breast screening occur in the UK

A

every 3 yrs between 50 and 70yr

30
Q

what are risk factors for invasive breast cancer

A
elderly females
PMHx/FHx of breast cancer or ovarian
endogenous oestrogen exposure (younger age of menarche and older age of menopause)
exogenous oestrogen exposure (OCP)
radiation exposure
31
Q

features of invasive breast cancer

A

RFs, PMHx/FHx of breast cancer or ovarian cancer
painless breast mass with nipple retraction or asymmetry
nipple discharge which can be serous, milky or bloody
axillary lymphadenopathy

32
Q

first line invesitigation for invasive breast cancer

A

mammogram

  • irregular spiculated mass
  • clusterered calcifications
33
Q

what is peau d’orange associated with

A

invasive breast cancer

34
Q

def of metastatic breast cancer

A

breast malignancy which has spread outside the breast and associated lymph nodes (axillary, infra + supraclavicular)

35
Q

how long do patients with MBC commonly survive

A

2 to 3 yrs

36
Q

aetiology of metastatic breast cancer

A

1 genetics
2 hormones
-oestrogen and progesterone

37
Q

how is metastatic breast cancer classified

A

patients with bone and soft tissue only - survival is longer

patients with other organ involvement - shorter survival

38
Q

risk factors for metastatic breast cancer

A
elderly females
PMHx or FH of breast or ovarian cancer
BRCA
tumour is >5cm
high number of positive nodes
39
Q

features of metastatic breast cancer

A

breast mass
bone pain (bone metastases
pleural effusion + SOB (lung metastases)
neurological features such as weakness or seizures (brain metastases)

loss of appetite and weight loss

40
Q

investigations

A

1 mammography
2 bloods
-FBC, if abnormal may indicate bone or liver metastases
-LFTs, if abnormal may indicate bone or huge liver metastases
-calcium, if elevated may indicate bone metastases
3 imaging
-CXR for lung metastases
-CT for liver or lung metastases
-bone scan for bone metastases