Breast Cancer Flashcards
RFs for breast cancer
FH Age Unopposed E2 Genetics Previous cancer
Genetic RFs for breast cancer
BRCA1 (chromosome 17)
BRCA2 (chromosome 13)
Factors increasing unopposed E2
Early menarche / Late menopause Obesity HRT Nulliparous Liver cirrhosis
Protective factors against breast cancer
Breastfeeding
Types of breast cancer
1) Invasive ductal carcinoma
2) Invasive lobular carcinoma
3) Non invasive ductal carcinoma in situ
4) Non invasive lobular carcinoma in situ
5) Medullary cancer
6) Colloid / Mucoid
7) Phyllodes tumour
Ix for breast lumps
Triple assessment
Ductal carcinoma in situ (DCIS) mammogram features
Microcalcification
Pre-malignant
Most common type of breast cancer
Invasive ductal carcinoma
Features of invasive ductal carcinoma
Feels firm
Features of medullary cancer
Subtype of ductal, less likely to spread
Younger people
Feels soft
Features of colloid / mucoid cancers
Post menopausal onset
Less likely to spread
Covered by mucin
Features of phyllodes tumour
Stromal tumour
Large
Mobile
Methods of breast cancer spread
Direct spread to muscle/skin
Lymphatic
Blood
Sign of lymphatic spread
Peau d’orange- inflammation of lymph tissue
Common metastasis sites of breast cancer
Bone
Lung
Liver
Brain
Breast cancer screening
Mammogram every 3 yrs
Age 47-73
Staging of breast cancer
Stage 1 to 4
Stage 1 breast cancer
Confined to breast
Mobile
Stage 2 breast cancer
Confined to breast
Mobile
Ipsilateral axilla lymph nodes
Stage 3 breast cancer
Fixed to muscle, not chest wall
Ipsilateral axilla lymph nodes may be fixed
Possible skin involvement
Stage 4 breast cancer
Fixed to chest wall
Distant mets
Most common site of breast lump
Upper outer quadrant
Presentations of breast cancer
Lump
Skin changes
Nipple changes
Mets
Nipple changes in breast cancer
Inversion
Discharge
Mx of stage 1-2 breast cancer
Wide local excision / Mastectomy
Sentinel node biopsy
Adjuvant chemotherapy
Hormonal therapy
Use of radiotherapy for breast cancer
Post wide local excision
Reduces recurrence
Breast reconstruction options
Tissue expanders
Implants
TRAM flap
Latissimus dorsi flap
TRAM flap
Transverse Rectus Abdominis Myocutaneous flap
Complications of breast surgery
Frozen shoulder
Lymphoedema
Long thoracic nerve palsy
Mx of stage 3-4 breast cancer
Hormonal therapy
Chemotherapy
Supportive Rx of mets