Breast Cancer

Question 1

How many women does breast cancer affect?

Answer 1

1 in 8 women

Question 2

How many men are affected by breast cancer?

Answer 2

Around 400 men in the UK each year are diagnosed

Question 3

See surgery block for…

Answer 3

Breast Surgery and demographics/risk factors etc for breast cancer Flashcards!

Question 4

Who gets radiotherapy for breast cancer?

Answer 4

Anyone who has had breast conserving surgery, and in high risk mastectomy cases

Question 5

What 2 ways can we do sentinel node clearance?

Answer 5

With coloured or with radioactive markers.

Coloured marker can be seen with eyes, radioactive detected by a magic boob wand (probe).

Question 6

What endocrine therapies can be given to breast cancer patients?

Answer 6

SERM (Tamoxifen)

Aromatase inhibitors e.g. letrozole

Question 7

What biological therapies can be offered for breast cancer (if appropriate)?

Answer 7

Herceptin/Trastuzumab (HER2 monoclonal antibody)

Question 8

What is Stage 0 breast cancer?

Answer 8

DCIS or LCIS (cancer cells only found in the membrane of ducts or lobules).

Question 9

What is Stage 1 breast cancer?

Answer 9

Tumour less than 2cm and contained within breast

Question 10

What is Stage 2 breast cancer?

Answer 10

Tumour is 2-5cm
OR
Has spread to nearby lymph nodes
OR
Both

Question 11

What is Stage 3 breast cancer?

Answer 11

Cancer has spread to lymph nodes or invaded local structures (muscle or skin)

Question 12

What is Stage 4 breast cancer?

Answer 12

Cancer with Mets.

Question 13

What are the poor prognostic factors for breast cancer?

Answer 13

• Young age
• Large tumour size
• High grade
• ER negtive
• Positive lymph nodes

Question 14

What % of pts who present to clinic wth nipple discharge have an underlying cancerous cause?

Answer 14

20%

Question 15

What are the 2 views we can use in mammography?

Answer 15

Caudio-cranial

Medio-lateral

Question 16

What is the classic description of breast cancer on mammography?

Answer 16

Irregular
Spiculated
Radio-opaque
Micro-calcifications

Question 17

Are microcalcifications always malignant?

Answer 17

No but we should always check them out with biopsy+histology if we see them.

Question 18

In younger patients, what can we do to image the breast tissue better?

Answer 18

MRI

Question 19

What is the best first test for a breast lump? Why?

Answer 19

USS - can image the lump as well as lymph nodes, and get an idea of if the lump is malignant or not (shape/outline/shadow).

Question 20

What are the benefits of FNA cytology?

Answer 20

Quick
Less uncomfortable
Lower morbidity

Question 21

What is the benefit of a core biopsy?

Answer 21

Can determine receptor status and grade of tumour i.e. better for malignant masses

Question 22

Where can breast cancer metastasise?

Answer 22

Lung
Liver
Bone
Brain
Adrenals
Ovaries

Question 23

When would axillary clearance be indicated (over sentinel lymph node biopsy)?

Answer 23

In malignancy with suspicious nodes

Question 24

Who can we use oestrogen antagonists in?

Answer 24

Pre- and post- menopause women

Question 25

Who can we use aromatase inhibitors in?

Answer 25

Post-menopausal women only

Question 26

What is Paget’s disease of the breast?

Answer 26

Infiltrating carcinoma of the nipple epithelium

Question 27

How common is Paget’s diseas of the breast?

Answer 27

1% of all breast cancers

Question 28

What % of breast cancer cases are metastatic at diagnosis?

Answer 28

5%

Question 29

Where should I do the rest of these questions from?

Answer 29

Breast Surger cards in Surgical Block deck