Breast cancer Flashcards
What is the triple approach for a breast lump
1) Clinical examination
2) Ultrasound and or mammogram
3) Biopsy to see the nature of the lump
Features of a suspicious malignant lump?
- Irregular and hard
- Fixed to chest wall
- Skin above is tethered
- Palpable lymph nodes in axilla
- Indrawn nipple/nipple involvement
- bone tenderness/pain
features of a benign breast tumour
- smooth edges
- Can be moved slightly when pushed
- Often found in both friends
Why would you want to do a blood test if you suspect a cancer?
to see if the patient has anaemia which would be indicative of internal bleeding
Why would you do other investigations If you suspect a cancer
Tp see if the carcinoma has spread to other sites
What are tumours stained with to see them under the slide
Haemotoxylin
What would a tumour look like under a slide
Nuclei are all different shapes and sizes and there is a high nuclear to cytoplasmic ration
How would you stage the tumour
TNM
How would you look at the biology of the tumour
Grade
Receptors (ER, HER2)
Growth Fraction
What does breast cancer usually arise from
Ductal or lobular cells
What happens if you increase the histological grade of the tumour
Chance of survival decreases
What does an oestrogen receptor positive look like under the microscope
The nuclei are dark and brown
What does an oestrogen receptor negative look like under a microscope
Niclei are dark and brown but the cells are arranged in a circle
What hormone receptor measurements are done for cases of breast cancer
Oestrogen and progesterone
Does oestrogen positive or negative have a better prognosis for breast cancer/.
Oestrogen receptor positive
how to work out Allred score
Add proportion score to intensity score and that would mean you can stratify patients into their responses for endocrine therapy
What does a higher Allred score mean
You have a higher chance for responding to endocrine therapy
When would there be a high chance of responsiveness to tamoxifen
If patient is ER and PR positive (second higher chance is when the patient is ER positive and PR negative)
When would a person benefit from chemo alone for breast cancer
If patient is endocrine non-responsive
When would a person benefit from endocrine therapy and also chemo
If they are endocrine responsive
When would a person benefit to endocrine therapy but not chemo
IF they are endocrine negative
What is HER2
membrane bound receptor
What does a HER2 positive slide look like
Strong staining
What does a negative HER2 look like
Weakly staining
What type of HER2 status is an indication of a good prognosis
Negative
