breast cancer Flashcards
what are risk factors for breast cancer ?
increased age previous breast cancer genetics - BRCA1/2 early menarche and late menopause late or no pregnancy HRT alcohol weight post radiotherapy
how does breast cancer present ?
lump mastalgia nipple discharge nipple changes change in size or shape lymphoedema dimpling of breast skin
who is in the breast cancer MDT ?
breast surgeon radiologist cytologist pathologist oncologist nurse counsellor psychologist reconstructive surgeon patient and partner palliative care
how is the T scored in breast cancer ?
Tx - cannot be asserted T0 - not palpable T1 - clinically palpable <2cm T2 - tumour size 2-5 cm T3 - >5cm T4 - invasive
how is the N scored in breast cancer ?
N0 - no regional lymph nodes palpable
N1 - regional nodes palpable mobile
N2 - regional nodes palpable - fixed
what are the two types of breast surgery ?
breast conservation surgery
mastectomy
what are complications of axillary treatment ?
lymphedema sensory disturbance decreased ROM of shoulder nerve damage vascular damage radiation induced sarcoma
what factors are associated with increased risk of disease recurrence ?
lymph node involvement tumour grade tumour size negative ER/PR positive HER2 receptor lymphovascular invasion
what are features of tamoxifen ?
blocks directly on ER receptor
20mg o/d over 5-10 years
more effective given after chemo
thromboembolic events risk
what are features of arimidex/letrozole (aromatase inhibitors)
inhibit ER synthesis
o/d for 5 years
only in postmenopausal women
risk of osteoporosis
who benefits most from chemotherapy ?
younger women <50
patients with increasing adverse prognostic factors
what are different options for chemotherapy ?
CMF combinations
anthracycline
taxane
what is the treatment for HER2 positivity ?
trastuzumab - Herceptin
monoclonal Ab against HER2 receptor
50% decrease risk of recurrence
