Breast Cancer

Question 1

What is the most common type of breast cancer?

Answer 1

Invasive ductal carcinoma

Question 2

What are the four main types of breast cancer?

Answer 2

Ductal carcinoma in situ
Lobular carcinoma in situ
Invasive ductal carcinoma - most common
Invasive lobular carcinoma

Question 3

What is pagets disease of the nipple?

Answer 3

This is eczema of the nipple and is associated with underlying breast malignancy, majority being invasive carcinomas

Question 4

What is the NHS breast cancer screening programme?

Answer 4

Age 47-73 women are meant to have a mammogram every 3 years

May be offered screening at a younger age if high risk of breast cancer

Question 5

What are the factors that determine wide local excision vs mastectomy?

Answer 5

Wide local excision:
-Solitary lesion
-Peripharal tumour
-Small lesion in large breast
-DCIS less than 4cm
Mastectomy
-Multifocal lesion
-Central tumour
-Large lesion in small breast
-DCIS greater than 4cm

Question 6

What therapy is commonly offered after wide local excision to reduce the risk of recurrence?

Answer 6

Radiotherapy

Question 7

What hormone therapy is used in breast cancer? Who can it be used in?

Answer 7

Tamoxifen can be used in hormonal positive tumours that have ER (oestrogen receptors)
Can be used if pre-menopausal, if post menopausal use aromatase inhibitors

Question 8

What biological therapies can be used in breast cancer?

Answer 8

Herceptin - trastuzumab - can be used in tumours that are HER2 positive

Question 9

How long is tamoxifen typically taken for following the removal of a tumour?

Answer 9

5 years

Question 10

What are the types of biopsy that could be used?

Answer 10

Core biopsy
Fine needle aspiration
Surgical biopsy

Question 11

What are the differentials for a breast lump?

Answer 11

Fibroadenoma
Breast cyst
Breast absesses (breastfeeding)
Fat necrosis
Pagets disease
Duct ectasia
Fat necrosis (trauma)