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Breast Cancer > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

Breast cancer tumours usually occur through which two mechanisms?

A
  • increase in oncogene function

- decrease in tumour suppressor gene function

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2
Q

What are the risk factors for breast cancer?

A
  • family history
  • age
  • uninterrupted oestrogen exposure
    • nulliparity
    • early menarche
    • late menopause
    • not breast feeding
  • first pregnancy over 30
  • BRCA1/BRCA2
  • previous breast cancer
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3
Q

Describe non-invasive ductal carcinoma in situ…

A
  • pre-malignant condition that is often seen as micro calcification on mammography
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4
Q

What are the three main types of breast cancer?

A
  • invasive ductal carcinoma in situ (70%)
  • invasive lobar carcinoma (10-15%)
  • medullary cancers (5%)
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5
Q

Describe the 4 levels of cancer staging…

A
  1. confined to breast and mobile
  2. growth confined to breast, mobile, lymph-node involvement in ipsilateral axilla
  3. tumour fixed to muscle (not chest wall), ipsilateral lymph nodes, maybe fixed, skin involvement
  4. complete fixation of tumour to chest wall, distant metastases
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6
Q

Describe the TNM staging…

A

T 1 < 2 cm T2 = 2-5 cm T3 > 5 cm
N1 = mobile ipsilateral lymph nodes N2 = fixed nodes
M1 = metastatic disease

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7
Q

What function do BRCA1 and BRCA2 usually have?

A

Tumour suppressor gene - they are dominant genes however cancer can occur when only one normal BRCA gene is present.

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8
Q

Which two cancers can the BRCA genes predispose you to?

A
  • breast cancer

- ovarian cancer

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9
Q

Which gene associated with breast cancer infers the most risk to males?

A

BRCA2

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10
Q

What are the three components of the Triple Assessment?

A
  • clinical assessment
  • mammography ± US
  • core biopsy ± fine needle aspiration cytology
    (IF DIAGNOSED, DISCONTINUE HRT IMMEDIATELY)
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11
Q

As well as a doctor, which two other professionals should a patient diagnosed with breast cancer be assigned?

A
  • named breast care nurse specialist

- psychological/psychiatric support

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12
Q

Why is immunohistochemistry testing important after the diagnosis of breast cancer?

A

Is is necessary to assess the tumour for:

  • oestrogen receptors
  • progesterone receptors
  • HER2 - (Human Epidermal growth factor Receptor 2)
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13
Q

What is triple negative breast cancer?

A

A cancer which does not have:

  • oestrogen receptors
  • progesterone receptors
  • HER2 receptors
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14
Q

Who should you offer genetic testing to following diagnosis of breast cancer?

A

Women under 50 with triple negative breast cancer, but no family history of breast or ovarian cancer

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15
Q

When should you offer US evaluation of the axilla?

A

All patients who are being investigated for early invasive breast cancer.
- if abnormal lymph nodes are identified then US guided needle sampling should be offered

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16
Q

When should you offer an MRI to patients with invasive breast cancer?

A
  • discrepancy regarding extent of disease from the triple assessment
  • if breast tissue density obstructs the mammography assessment
  • to assess the tumour size if breast conserving treatment is being considered for invasive lobular cancers
17
Q

How should you treat early breast cancer?

A
  • surgically, with pre-operative systemic therapy for those wishing to undergo breast-conserving therapy
18
Q

How would you treat locally advanced of inflammatory breast cancer?

A
  • usually mastectomy, occasionally breast-conserving treatment, followed by radiotherapy
19
Q

Who would you offer neoadjuvant treatment to?

A
  • oestrogen-receptor negative
  • HER-postive should be offered pertuzumab
  • if triple negative then chemo. should include platinum and anthracycline
20
Q

When would you consider further breast surgery following breast conserving treatment?

A

When invasive cancer/ DCIS is found within the 2 mm margin of the excised tissue.

21
Q

What is Paget’s Disease?

A

A condition that develops in the nipple or areola. 50% have a lump behind the nipple which is an invasive breast cancer 9/10

22
Q

What are the symptoms of Paget’s Disease?

A
  • red, scaly rash of skin over nipple + areola

- itchy/painful

23
Q

How is Paget’s Disease diagnosed?

A
  • with a biopsy
24
Q

How would you manage Paget’s Disease?

A
  • offer breast conserving surgery with removal of the nipple-areola complex
25
Q

What should be discussed regarding breast reconstruction?

A
  • timing (time of mastectomy or later?)
  • different breast reconstruction options
  • how timing of breast reconstruction affects the options available
  • uncertainty of long-term outcomes if having radiotherapy

Breast Cancer (1 decks)

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