Breast Cancer Flashcards
Risk factors for breast cancer
>/= 50 Family history Atypical hyperplasia Early menarche Late menopause Obesity Breast density
T/F African Americans have a lower age of onset for breast cancer compared to caucasians
true
Obesity and breast cancer
- oestrogen = produce estrogen
- Insulin growth factor
- Inflammation
T/F a first degree relative with breast cancer triples your risk of breast cancer
false
doubles
T/F if you have 2 first degree relatives with breast cancer increases your risk 5x
true
If you have a proven BRCA1 or BRCA2 mutation your lifetime risk of developing breast cancer is ____%
80
If no genetic testing is done, when would you suspect someone has a genetic factor in breast cancer?
- cancer occurs at early age
- history of ovarian cancer
- bilateral breast cancer
BRCA1 is on what chromosome?
BRCA2 is on what chromosome?
17
13
T/F having BRCA2 has a increased lifetime risk of developing breast cancer compared to BRCA1
False!
BRCA 1> BRCA2
BRCA1 and BRCA2 mutations leads to what?
genomic instability
T/F either parent can pass on a BRCA1/2 mutation
true
T/F not having kids increases your risk for breast cancer
true
T/F by the time breast cancer is palpable the cancer may have been present for years
True
T/F when breast cancer spreads to the axilla it is considered metastatic
false!
considered local-regional spread
Positive axillary lymph nodes are predictive of what?
distant micro-metastasis
T/F approximately 70% of new cases of breast cancer are ER(-)
false
70% ER(+)
Breast cancer presentation
painless lump
Mass usually solitary, unilateral, hard, irregular, non-movable
Which is better self breast exam or mammography?
mammography!
little benefit to self-exam
How does breast density relate to breast cancer?
extremely dense more likely to have breast cancer
T/F calcium in your diet can cause calcium deposits in the breast
False!
Calcium deposits in your breast is indicative of what?
breast cancer
Of the 10% abnormal mammography’s are most benign or abnormal and need a biopsy?
most are benign!
Of those that are biopsied those are majority benign
T/F it is important to re-assure patients that a single abnormal mammogram is usually not cancer
true
T/F DCIS does not have an independent blood supply
true
T/F all breast cancer is curable
false!
Metastatic is NOT
Is radical mastectomy the superior surgery?
no!
Should never be done!!!
Can sentinel lymph node biopsy be used in all breast cancers?
NO!
not in DCIS
What is a proliferative marker of breast cancer?
Ki-67
Describe African americans risk for breast cancer
younger age
larger tumors
more frequent triple negative
higher rates of p53 mutations
Triple negative breast cancer
Her 2 (-) Estrogen receptor (-) Progesterone receptor (-) *more often BRCA1 mutation and African American
HER 2 positive breast cancer
ER (-)
PR (-)
LN+
High grade
What drugs can be used in chemoprevention for breast cancer?
SERMS
Estradiol antagonists
Aromatase inhibitors
Who would you not use AIs in?
pre-menopausal women
Who would you not use raloxifene in?
DCIS
Who would you use raloxifene in?
May be preferred with history of endometrial cancer or thrombosis
Bone preserving
What SERMS are used in breast cancer?
Tamoxifen, Raloxifene, Toremifene
SERMs ADE
VTE
endometrial cancer
post-menopausal symptoms
AI ADE
osteoporosis
musculoskeletal pain
Are 1st gen or 3rd gen AIs preferred in breast cancer?
third gen
Letrozole, anastrozole, exemestane
