Breast Cancer Flashcards
Where does cancer tend to arise?
The ducts
Lobes
What are DCIS and LCIS?
Ductal carcinoma in situ
Lobular carcinoma in situ
They are both pre-malignant i.e. have not breached the basement membrane
S+S:
Obviously there is a lump of thickening in breast or armpit!
What skin changes may they notice? - 2
Can the breast be painful?
What may they notice happen to the nipples? - 3
Where will they get lymphadenopathy?
Dimpling or ulcers
Yes, it can be painful but it is rare
Inversion
Discharge
Rash
Neck and axilla
S+S:
Paget’s Disease:
- What does it do to the breast? - 5
- Is it cancerous?
- They are usually unilateral. If it is bilateral, what other diagnosis should be considered?
Inflammatory breast cancer:
- What does the breast look like?
- They also get itch and inflammation. What signs point to inflammation?
- What else can occur?
Breast eczema
Eczemtoid skin Itching Pain Bloody discharge Lump
Yes - 50% can be cancerous
Peau d’orange
Pain
Swelling
Warmth
Nipple inversion
Risk factors:
What could cause increased oestrogen exposure? - 6
What gene is the commonest cause of inherited breast cancer?
Early menarche Late menopause HRT OCP Nulliparity Obesity
BRCA
Screening:
How often is it done?
What age range?
Those with BRCA are screened annually with MRI and mammogram!
Every 3 yrs
50 to 70 yrs
Referral criteria:
What would warrant a referral? - 4
Breast lumps or nipple changes
Postmenopausal
Clinical features of malignancy
FH
Investigations:
(1) History and examination
(2) What imaging is used?
(3) Histology:
- How is the tissue obtained?
-
Mammogram +/- USS
MRI is unsure
Fine needle aspiration cytology (FNAC)
Management:
What 4 Rx’s can be done?
Surgery, chemo, radio or hormonal therapy
Complications:
What are some symptoms of bone mets?
What are signs of liver mets?
What are signs of lung mets?
What are signs of CNS mets?
Bone pain
Pathological fractures = bisphosphonates used
Hepatomegaly
Pleural effusion
Headache
Patchy CN lesions
