Breast Cancer Flashcards
What is breast cancer?
Breast cancer = malignancy arising from the breast tissue • More common in LHS • 50% arise in upper outer quadrant • Il o DCIS (ductal carcinoma in situ) o Invasive ductal carcinoma o Invasive lobular carcinoma o In situ/ invasive papillary carcinoma
What is the aetiology of breast cancer?
Both genetics and environment are important
o Genetics
- 1st degree relative – particularly pre-menopausal
- BRCA-1, BRCA-2
- FH is the strongest predictor of risk
o Hormones – oestrogen exposure
- Late age of first pregnancy
- Nulliparity
- Early menarche
- Late menopause
- Obesity
- OCP
- HRT
o Dietary
- Processed meats
- High fat intake
- Alcohol
o Exposures
- Tobacco smoke
- Environmental carcinogens
- Radiation exposure
What are the risk factors for breast cancer?
FH
Previous breast disease
Hereditary breast-ovarian cancer syndrome
o 85% caused by BRCA1/2 mutations
o Up to 80% lifetime risk
Old age of menopause Old age of first pregnancy (>30years) Nulliparity Low exercise/obesity HRT Not breast feeding
What is the epidemiology of breast cancer?
Lifetime risk of 1 in 9 for UK women
20% of all malignancies
20,000 new cases in the UK each year
o Incidence is increasing 1% a year
Most common female cancer
o Rare in men (only 1% of all cases)
Rare below age 30
What are the symptoms of breast cancer?
25% present as abnormal mammogram
Breast lump
Nipple discharge/inversion
o Unilateral
o May be bloody
Breast tenderness
What are the signs of breast cancer?
Breast lump
o Smooth or nodular
Skin change
o Peau d’orange
Axillary lymphadenopathy
What investigations can be done for breast cancer?
Triple assessment
o Clinical examination
o Mammography/US - IF >35 – both, IF <35 – US only
o Histology/cytology
- FNA – best for cystic lumps
- Core biopsy – best for new lumps or solid lumps
- Hormone receptor testing (oestrogen, progesterone)
Genetic testing for BRCA-1/2
