Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

304: Urology + Breast > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

Epidemiology

A

Most common cancer in UK

Affects 1/8 women by 80
- Incidence= 20K/ year

5th most commonest cause of cancer deaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Genetic associations with breast Cancer

A

5% associated with BRCA mutations
- BRCA1= Breast ca, Ovarian Ca

  • BRCA2= Breast Ca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hormonal association with breast cancer

A

Increased oestrogen exposure
- Early menarche (<12), late menopause (>55)
- HRT, OCP (<45)

Obesity

First child >30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors for breast cancer (6)

A

Female (1:200)

Older

Proliferative breast disease

Genetic associations
- BRCA1, 2

Family history- 1st degree relative= 2x risk

Oestrogen exposure

Having children >35/ no children

Caucasian <40
Black > 40
- Asians are at low risk

(Breast feeding is protective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Subtypes of Breast Ca

A

Ductal carcinoma
- Arising from lining of the lactiferous ducts.
- Includes Ductal carcinoma in situ (DCIS)= non invasive
- Invasive ductal carcinoma

Lobular carcinoma
- Developing from lobules supplying the ducts

Phyllodes tumour

Medullary
- Affects younger Pts

Colloid/ mucinous
- Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pathology of breast Ca

A

Cancer typically arises from lining of lactiferous ducts/ lobules supplying the ducts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DCIS/ LCIS

A

Ductual carcinoma in situ
- Non-invasive, pre-malignant cancer arising from duct
- Has potential to become invasive
- Presents as microcalcification on
mammogram.

Lobular carcinoma in situ
- Neoplastic proliferation of cells in lobules
- Increased risk of invasive lobular/ ductal carcinoma developing in either breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common sites of spread for breast Ca

A

Local= muscle and skin

Lymph nodes

Bones, Lungs, Liver, Brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Breast Ca presentation

A

Breast lump
- Usually painless
- Commonly in upper, outer quadrant

Axillary lymphadenopathy

Skin changes
- Persistent eczema= Paget’s
- Peau d’orange (orange peel appearance)

Nipple
- Discharge
- Inversion

Signs of mets
- Bone pain
- SOB
- Abdominal pain
- Seziures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

First line investigation for Breast ca

A

Mammography
- For screening and diagnosis

Findings
- Clustered calcification (focal/ diffuse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Investigations for breast Ca

A

Fine needle/ Core biopsy

Sterotactic biopsy (microcalcifications)

MRI/ USS
- Better tissue enhancement
- Evaluates axillary node envolvement

Hormone receptor testing
- Oestrogen and progesterone

HER2 receptor testing/ Gene expression assays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Primary invasive breast cancer

A

Cancer that originates in the duct/ lobule of the breast, and has penetrated past the basement membrane.
- Has not spread to other organs but to surrounding tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment of early stage invasive breast Ca
- Stage 2-2B (T2 N1 M0)

A
  1. Lumpectomy/ total mastectomy
    - Can include breast reconstruction.
    - Neoadjuvant/ adjuvant chemo

+ Lymph node resection

HER2 positive
- Trastuzumab +/- pertuzumab (neoadjuvant or adjuvant)

  • A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment of early stage invasive breast Ca
- Stage 2-2B (T2 N1 M0)
- HER2 positive disease

A

Lumpectomy/ total mastectomy

  • Trastuzumab +/- pertuzumab (neoadjuvant or adjuvant)
  • Trastuzumab ematansine

Neratinib (high risk patient)
- Trialed after trastuzumab based therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of early stage invasive breast Ca
- Hormone receptor-positive disease
- Pre and post menopausal

A

Lumpectomy/ total masectomy

Pre-menopausal:
1. Tamoxifen
2. Ovarian function suppression
- Goserelin

Post menopausal:
1. Neoadjuvant/ adjuvant
aromatase inhibitor
- Anastrozole, letrozole, exemestane

+ radiotherapy if mastectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of locally advanced stage invasive breast Ca

A
  1. Neoadjuvant chemo

+ Surgery/ Lymph node resection

17
Q

Risk categories
- Low (2)
- Moderate (6)
- High (5)

A

Low= 12.5% lifetime risk
- No FHx
- 1st/ 2nd degree relative has BC >45

Moderate risk= 25%
- One 1st degree relative <40
- Two 1st/2nd degree relatives with BrCa <60
- Two 1st/2nd degree relavtives with OvCa
- Bilateral BrCa <60
- Three 1st/2nd degree with BC/ OvCa
- First degree male relative with BC

High risk= 50%
- 4 1st/2nd degree relatives with BC/ OvCa

  • One family member with BC +Ca
  • 3 relatives with BC <40
  • Askanazi jew relative
  • Cancer syndrome in family
18
Q

Hodgkins disease and breast cancer

A

Treated with HD in children = increased risk 25 years post treatment
- Risk = 15-33%

When treated in young adulthood (20-29)
- increased risk (15-25), not as high as childhood treatment.

19
Q

Screening for BC

A

Every 3 years from 47-70

Specificity
- False negative rate= 10%

20
Q

Types of benign tumours

A

Fibroadenoma
- Most common benign growth

Adenoma
- Benign glandular tumour

Papilloma
- Intraductal, Subareolar region

Lipoma

Phyllodes
- Fibroepithelial= stromal and epithelial tissue

21
Q

Fibroadenoma
- Features
- Presentation
- Management

A

Features
- Stromal and epithelial benign growth of lobules
- Common in women of reproductive age

Presentation
- Very mobile
- Well defined and rubbery
- Mainly <5cm
- Multiple/ bilateral

Management
- Low malignant potential
- Left in situ with follow up
- Indication for incision= >3cm

22
Q

Adenoma
- Features
- Presentation

A

Benign glandular tumour
- Occurs in elderly

Presents
- Nodular, similar to carcinoma
- Diagnose via triple assessment: examine, image, biopsy.

23
Q

Papilloma
- Features
- Presentation
- Management

A

Benign intraductal breast lesion, subareolar

Presentation
- Bloody/ clear discharge

Management
- Biopsy
- Microdochectomy

24
Q

Lipoma
- Features
- Presentation
- Management

A

Benign adipose tumour

Presents
- Soft and mobile mass
- Low malignant potential

Management
- Removed if enlarging significantly/ causing compressive symptoms

25
Q

Phyllodes tumour
- Features
- Presentation
- Management

A

Fibroepithelial
- Epithelial and stromal (leaf like appearance)

Presentation
- Older age group
- Grow rapidly

Management
- 1/3 have malignant potential
- Wide excision/ mastectomy

26
Q

Treatment of:
- DCIS
- LCIS

A

DCIS
- Wide complete excision
- If widespread multifocal= complete mastectomy.

LCIS
- Low grade= monitoring
- Invasive, BRCA1/2 = Bilateral prophylactic mastectomy

27
Q

Invasive ductal carcinoma
- Features/ types

A

Most common type of breast carcinoma

Types
- Tubular
- Cribriform
- Papillary
- Colloid

28
Q

Nottingham prognostic index

A

Staging system for primary breast cancer prognosis
- Lower score= higher survival rate

Feattures
- Size
- Grade (bloom-richardson classification)
- Nodal status (number of lymph nodes involved)

29
Q

Receptor status

A

Cancers checked for responses to certain hormones/ growth factors before targeted therapy.

receptors checked
- Oestrogen
- Progesterone
- Human growth factor (HER)

30
Q

Breast screening

A

50-70 age group
- Invited for mammogram every 3 year.

31
Q

Paget’s disease of the nipple
- Description
- Presentation
- management

A

Roughing/ redding/ slight ulceration of nipple
- Indicates underlying neoplasms
- Malignant ductal cells in epidermis

Presentation
- Itching/ redness in nipple/ areola
- Flaking thickened skin
- area affected is painful/ sensitive
- Flattened nipple +/- discharge
- ALWAYS involves nipple, whereas eczema always involves areola and spares nipple.

Management
- surgery
- underlying malignancy= radiotherapy

32
Q

Trastuzumab (known as _____) is a ______ that acts by______

A

Herceptin
- Monoclonal antibody
- Blocks HER2 receptors

33
Q

Pertuzumab (known as _____) is a ______ that acts by______

A

Perjeta
- Monoclonal antibody
- Blocks HER2 receptors

34
Q

What targetted breast cancer therapy has a risk of cardiotoxicity?

A

Herceptin (Trastuzumab)

35
Q

What targetted breast cancer therapy has a risk of alopecia, neutropenia and anaemia?

A

Pertuzumab (Perjeta)

36
Q

Neratinib (known as _____) is a ______ that acts by______

A

Nerlynx
- tyrosine kinase inhibitor
- Blocks HER2 receptor

37
Q

What targetted breast cancer therapy has a risk of diarrhoea, stomatitis and muscle spasms?

A

Neratinib

38
Q

Adverse effects of tamoxifen

A

Serious effects
- Stroke, VTE
- Endometrial cancer
- Visual disturbance

Common
- Hot flushes
- Vaginal bleeding/ irregular periods

39
Q

Adverse effects of aromatase inhibitors

A

Osteoporosis, joint disorders

Alopecia

304: Urology + Breast (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions