Breast cancer

Question 1

What are the clinical features of breast cancer

Answer 1

Breast size changes

Breast asymmetry

Lumps

Mastalgia

Paget’s disease of the nipple

Nipple retraction

Nipple discharge & bleeding

‘Peu d’orange’ nipple

Question 2

What are the 2 types of breast cancer

Answer 2

Invasive

Non-invasive

Question 3

What are the different types of invasive breast cancer

Answer 3

Ductal

Lobular

Medullary

Mucinous

Papillary

Tubular

Question 4

What are the different types of non-invasive breast cancer

Answer 4

Ductal Carinoma In Situ (DCIS)

Lobular Carcinoma In Situ (LCIS)

Question 5

What is the difference between invasive and non-invasive breast cancer

Answer 5

Non-invascive carcinomas are still attached to the basement membrane so they are ‘in situ’

Question 6

What test is used to differentiate between lobular and ductal breast cancers and what is the difference between the two

Answer 6

E-cadherin test

Ductal -> E-cadherin +ve

Lobular -> E-cadherin -ve

Question 7

So if an E-cadehrin test is +ve for a breast cancer, what type of breast cancer is diagnosed

Answer 7

Ductal

Question 8

What is the gold-standard investigation for breast cancer

Answer 8

Mammogram

Question 9

What type of imaging is used in a mamogram

Answer 9

USS

Question 10

At what age are all women offered a mamogram to screen for breast cancer

Answer 10

50

Question 11

Along with mamograms, what other investiations are used for breast cancer

Answer 11

FNA cytology

Core biopsy

Bloods

USS

Question 12

A core biopsy sample must be taken of what prior to surgery for breast cancer

Answer 12

Sentinel node

Question 13

What are the 2 diagnostic signs of breast cancer on a mammogram

Answer 13

Soft tissue opacities

Microcalcifications

Question 14

Why are mammograms less sensitive in younger woman

Answer 14

As these women have higher amounts of glandular tissue

Question 15

What are some of the risk factors for breast cancer

Answer 15

Old age

Being a woman (men can still get it tho bro)

Early menarche

Late menopause

Family history

Previous history

HRT use

Contraceptive use

No pregnancies (0 parity)

Question 16

Does having a high parity (lots of baby children) put you at a higher risk of breast cancer

Answer 16

Nah it’s the opposite mate

Question 17

What genes are responsible for breast cancer’s being linked in families

Answer 17

BRAC-1

BRAC-2

p53

Question 18

Early menarche is a risk factor for breast cancer, what does it mean

Answer 18

Having your first period early doors

Question 19

What are the treatments for breast cancer

Answer 19

Radiotherapy

Chemotherapy

HRT

Anti-HER2 therapy

Surgery

Question 20

What biologic is an example of anti-HER2 therapy that is used to treat breast cancer

Answer 20

Tratuzumab

Question 21

What is used in HRT as treatment for breast cancer

Answer 21

Tamoxifen

Question 22

What are the surgical treatments for breast cancer

Answer 22

Mastecomy

Breast conserving surgery

LN (sentineal) removal

Question 23

What needs to be removed prior to surgery for breast cancer

Answer 23

Senitenal LN

Question 24

What are some of the potential causes of breast cancer

Answer 24

Genetics (BRAC-1, BRAC-2 & p53)

Fat necrosis

Question 25

What tumour markers are used to detect breast cacner

Answer 25

Cancer antigen-125 (CA-125)

HER-2

Question 26

What are some of the complicatinos of breast cancer

Answer 26

Breast cancer in the other breast

Mets

Death

Reoccurance

Question 27

When is anti-HER2 therapy used as treatment for breast cancer

Answer 27

After chemotherapy

Question 28

When treating breast cancer in younger women, what is more effective out of radiotherapy or chemotherapy

Answer 28

Chemo

Question 29

Give 2 examples of complications of radiotherapy

Answer 29

Radiation pneumonitis

Telangictasia

Question 30

Radiotherpay and chemothearpy can be used as either neoadjuvants or adjuvants, what is the difference between the two

Answer 30

Neoadjuvants -> Before surgery

Adjuvants -> After surgery