Breast Cancer Flashcards
Definition of breast cancer?
Malignancy of breast tissue?
Most common type and epidemiology of breast cancer?
Invasive ductal carcinoma
- most common cancer in the UK
- affects men as well, but obviously women more
What is staging of cancer?
analysis of Spread
What mnemonic used to describe staging?
TNM
- tumour
- nodes
- metastases
What is grading of cancer?
analysis of Differentiation
What grading system is used in breast cancer?
Nottingham grading system
What are the invasive and non-invasive forms of breast cancer?
Non-invasive - DCIS (ductal carcinoma in situ)
Invasive - infiltrative ductal carcinoma (75%), infiltrative lobular carcinoma, Paget’s disease of the breast
Risk factors for breast cancer?
Age FHx - 1st degree relative Obesity Increased oestrogen exposure Alcohol Fatty diet Previous chest radiation Nulliparity Familial breast cancer
Evidence of increased oestrogen exposure?
Early menarche (<11) Late menopause (>55) HRT/OCP
What gene and other cancers is breast cancer associated with?
BRCA 1/2
- ovarian and pancreatic cancer
SCTF presentation of breast cancer?
S - increased size, lump, skin changes
C - hard lump, irregular margins, redness, non-compressible
T - generally painless, inflammatory breast cancer (painful + warm)
F - tethered to underlying tissue, immobile
Symptoms of metastases from breast cancer?
Bone pain
Shortness of breath
Neurological symptoms (rare)
Skin changes in breast cancer?
- Armpit skin thickening
- Peau d’orange
- Skin dimpling
- Nipple discharge (sometimes bloody)
- Nipple inversion
- Eczematous-looking skin (Paget’s)
Investigation process to confirm suspected breast cancer?
Triple assessment
- clinical examination
- imaging (<35 = USS, >35 = mammogram)
- tissue diagnosis (FNA, core biopsy)
Appropriate investigations once breast cancer is diagnosed?
Staging (commonly mets to liver, lung, bones)
- CXR
- Liver USS
- CT (brain/chest)
- bone scan
Bloods (same principle)
- FBC
- U&Es
- calcium + bone profile
- LFTs
- ESR
Management of breast cancer?
Depends on type, stage, and grade of cancer Includes: - surgery - medications - chemotherapy - monoclonal antibodies - radiotherapy
Appropriate surgical management options for breast cancer?
Total mastectomy
Lumpectomy
Sentinel LN biopsy or axillary LN clearance (depends on number of LNs removed)
Appropriate medication management options for breast cancer?
Oestrogen receptor antagonists (tamoxifen)
Aromatase inhibitors (letrozole)
Types of chemotherapy viable in management of breast cancer?
Neo-adjuvant or adjuvant
Why/when is radiotherapy useful in management of breast cancer?
Reduces risk of recurrence post-surgery
