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OSCE 3 > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

How common in breast cancer?

A

Affects 1 in 9 women

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2
Q

What are the risk factors?

A

Family history, age, uninterrupted oestrogen exposure, nulliparity, 1st pregnancy over 30 years old, early periods, late menopause, HRT, obesity, BRCA genes, not breastfeeding.

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3
Q

What are the types of breast cancer?

A

Non-invasive ductal carcinoma-in-situ (CIS), non-invasive lobular CIS, invasive ductal carcinoma, invasive lobular carcinoma are the main ones.

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4
Q

Describe non-invasive ductal cis

A

Premalignant and seen as micro calcification on mammography (unifocal or widespread).

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5
Q

Describe non-invasive lobular cis?

A

Rarer than non-invasive ductal cis and tends to be multifocal.

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6
Q

Which is more common invasive ductal carcinoma or invasive lobular carcinoma

A

Most common type (70%) is invasive ductal carcinoma, invasive lobular carcinoma accounts for 10-15%.

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7
Q

What percentage of breast cancers are oestrogen receptor positive?

A

60-70%, this is a better prognosis

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8
Q

What percentage of breast cancers are HER-2 receptor positive?

A

About 30%, this is a poorer prognosis and indicates aggressive disease.

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9
Q

How genetic is it?

A

Only 5% of breast cancers are caused by inheriting an altered gene

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10
Q

What is the prognosis?

A

More than 80% of women survive breast cancer beyond five years. Around 78% of women survive beyond 10 years.

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11
Q

When can I have breast screening?

A

In the UK, women aged 50 to 70 are invited for breast screening every three years as part of a national screening programme.

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12
Q

What will happen when I go for breast screening?

A

Breast screening involves an x-ray examination of the breasts, called a mammogram. Breast screening usually takes about half an hour

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13
Q

When will I get the results from the breast screening?

A

The results are usually sent to you and your GP within two weeks. Sometimes the results letter may ask you to go back for further assessment (recall). It will explain the reasons why.

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14
Q

What does it mean if I get a recall after my breast screening?

A

A recall doesn’t necessarily mean you have breast cancer but you may need more tests to find out what has shown up on the mammogram.

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15
Q

Does wearing an underwire bra increase your risk of breast cancer?

A

No, wearing an underwire bra does not increase your risk of breast cancer.

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16
Q

Can an injury to the breast cause breast cancer?

A

No, it can’t. An injury, such as falling or being hit in the chest, will not cause breast cancer.

17
Q

Does it matter what type of HRT I take?

A

The type you take and how long you take it for may affect the risk, and the risk also reduces over time once you stop taking HRT.

18
Q

What type of HRT is best?

A

Oestrogen-only HRT has a lower risk than combined HRT.

19
Q

What does multi-centric mean?

A

there’s more than one area of breast cancer in different quarters of the breast.

20
Q

What does multi-focal mean?

A

more than one area has been seen but only in one quarter of the breast.

21
Q

What does grade 1 breast cancer mean?

A

(well differentiated) – the cancer cells look most like normal cells and are usually slow-growing

22
Q

What does grade 2 breast cancer mean?

A

(moderately differentiated) – the cancer cells look less like normal cells are growing faster

23
Q

What does grade 3 breast cancer mean?

A

(poorly differentiated) – the cancer cells look most changed and are usually fast-growing.

24
Q

What does stage 1 mean?

A

The cancer is confined to the breast and mobile

25
Q

What is stage 2 cancer?

A

Growth confined to the breast, it is mobile, lymph nodes in ipsilateral axilla

26
Q

What is stage 3 cancer?

A

Tumour fixed to muscle but not chest wall, ipsilateral lymph nodes matted and may be fixed, skin involvement larger than tumour

27
Q

What is stage 4 ?

A

Complete fixation of tumour to chest wall, distant metastasis

28
Q

What is the treatment for stage 1 and stage 2 cancer?

A

Surgery, radiotherapy, chemotherapy, endocrine agents

29
Q

What are the side effects of radiotherapy?

A

Pneumonitis, pericarditis and rib fractures

30
Q

What drug is used is oestrogen receptor positive cancer?

A

Tamoxifen

31
Q

What are the side effects of tamoxifen?

A

May rarely cause uterine cancer so warn to report vaginal bleeding

32
Q

What drug is given to HER-2 positive cancers?

A

Trastuzumab

OSCE 3 (20 decks)

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