Breast Cancer

Question 1

What are the risk factors for breast cancer?

Answer 1

Increasing age
Female sex
Caucasian
Positive family history
Endogenous oestrogen exposure - oral contraceptive pill, early menarche, late first pregnancy, nulliparity
Alcohol consumption
Radiation exposure

Question 2

Inherited mutations in which genes cause an increased risk of breast cancer?

Answer 2

BRCA1

BRCA2

Question 3

Where in the breast does breast cancer usually arise from?

Answer 3

Terminal duct lobular units

Question 4

Other than a breast lump what are the potential signs of breast cancer?

Answer 4

Increasing size of the mass
Nipple discharge
Axillary lymphadenopathy
Skin thickening or discolouration
Retraction or scaling of the nipple

Question 5

What investigations should be undertaken for suspected breast cancer?

Answer 5

Physical examiantion
Mammography or ultrasound
Biopsy

Question 6

When should ultrasound be used as an investigation for suspected breast cancer?

Answer 6

Patients <40 years

Question 7

What surgical treatment can be used for breast cancer?

Answer 7

Wide local excision

Mastectomy

Question 8

Describe the use of sentinel lymph node biopsy in breast cancer treatment?

Answer 8

A surgical procedure conducted alongside lumpectomy / mastectomy which is used to evaluate axillary node in early breast cancer
If it is positive then axillary node clearance will be required

Question 9

Why might neoadjuvant chemotherapy be used in the treatment of breast cancer?

Answer 9

To downsize large/inoperable tumours to make them operable or to enable lumpectomy

Question 10

What. drug can be given to breast cancer patients who have a. HER2 positive tumour?

Answer 10

Traztuzumab

Question 11

What drug can be given to breast cancer patients who have an oestrogen receptor positive tumour?

Answer 11

Tamoxifen

Question 12

What is ductal carcinoma in situ?

Answer 12

DCIS is a precancerous lesion characterised by a mass of neoplastic cells that arise from epithelial cells in the terminal duct lobular unit

Question 13

What is Paget’s disease of the breast?

Answer 13

This occurs when ductal carcinoma, either in situ or invasive, extends up to the lactiferous ducts and into the nipple and areola

Question 14

Describe the presentation of Paget’s disease of the breast?

Answer 14

Eczematous skin lesion or persistent dermatitis in the nipple and adjacent areas

Question 15

Where does lobular carcinoma in situ arise?

Answer 15

LCIS arises in lobules and acini to the terminal duct lobular unit

Question 16

What type of non-invasive breast cancer is associated with an increased risk of breast cancer developing in both. breasts?

Answer 16

Lobular carcinoma in situ

Question 17

What is the most common type fo invasive breast. cancer?

Answer 17

Invasive ductal carcinoma

Question 18

How does invasive breast cancer typically metastasise?

Answer 18

Via the lymphatic vessels

Question 19

What type of invasive breast cancer is commonly associated with LCIS?

Answer 19

Invasive lobular breast cancer

Question 20

What type of breast cancer is associated with low E-cadherin expression?

Answer 20

Invasive lobular carcinoma

Question 21

What type of breast. cancer commonly presents as a well-circumscribed palpable mass which can mimic benign lesions?

Answer 21

medullary carcinoma

Question 22

What type of breast cancer is more common in younger women and is associated with. BRCA1 mutation?

Answer 22

Medullary carcinoma

Question 23

Why does inflammatory breast carcinoma present with peas d’orange, breast tenderness, pruritic and warm erythematous skin. T/F?

Answer 23

These symptoms are caused by the blockage of dermal lymphatics