Brainscape's Knowledge GenomeTM

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


See full index

Year 3 - Met3b > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

How many women are affected by breast cancer

A

1 in 9 women are affected by breast cancer

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

How many males account for breast cancers

A
  • males account for 1% of breast cancers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for breast cancer

A
  • family history and BRCA genes
  • past medical history of breast cancer
  • age
  • not breastfeeding
  • lifestyle
  • radiation exposure before 40
  • prior benign or premalignant breast changes such as radial scar, atypical hyperplasia

Increased oestrogen exposure

  • nulliparity
  • 1st pregnancy over the age of 30
  • early menarche
  • late menopause
  • HRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What gene mutation is breast cancer linked to

A
  • Minority of breast cancers are linked with an inherited mutation e.g. BRCA1, BRCA 2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are high risk families in having a genetic link to breast cancer

A
  • 4 or more relatives with breast/ovarian cancer
  • 3 relatives under the age of 60
  • 2 relatives under the age of 40
  • 1 relative with both or bilateral breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are lifestyle risk reduction strategies of breast cancer

A
  • Early childbirth (younger than age 30)
  • Exercise 3-5 hours per week
  • Maintain normal weight
  • Avoid smoking/alcohol
  • Avoid prolonged hormone replacement especially with combined estrogen and progestin therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the presentation of breast cancer

A
  • Axilla = mass or pain
  • Breast - palpable mass, thickening, pain (less common)
  • nipple - discharge and retraction
  • Skin - oedema, Peau d’orange (pulling of the ligaments that tether hair follicle), erythema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathway of diagnosis of breast cancer

A
  • triple assessment
  • MDT discussion
  • personalised Treatment plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the common sites of distant metastases in breast cancer

A
  • brain
  • pleura/lungs
  • lymph nodes
  • skin
  • liver
  • bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name the 4 stages of breast cancer

A

Stage 1
- confined to the breast, mobile

Stage 2

  • growth confined to the breast, mobile
  • lymph nodes in ipsilateral axilla

Stage 3

  • tumour fixed to muscle but not chest wall
  • lymph nodes in ipsilateral axilla and fixation
  • Skin involvement larger than tumour

Stage 4
- complete fixation to chest wall and distant metastasis

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

Describe the T part of the TNM staging in breast cancer

A
  • TX - primary tumour cannot be assessed
  • TO - no evidence of primary tumour
  • Tis - carcinoma in situ
  • T1 - tumour 2cm or less in greatest dimension - A = 0.1-0.5cm, B = 0.5-1cm, C - 1-2cm
  • T2 - tumour 2-5cm in greatest dimension
  • T3 - tumour >5cm in greatest dimension
    T4 - a) Fixation to chest wall; b) Oedema (peau d’orange) or skin ulceration; c) Both fixation to chest wall and oedema/peau d’orange; d) Inflammatory carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the N and M stage of tumour staging in breast cancer

A

N0 – No lymph node involvement
N1 – Mobile ipsilateral nodes
N2 – Fixed nodes

M0 – No mets
M1 – Distant mets

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

What are the types of breast cancer

A
  • Non invasive ductal carcinoma in situ
  • non invasive lobular carcinoma in situ
  • invasive lobular carcinoma
  • invasive medullary carcinoma
  • invasive colloid/mucoid carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common type of breast cancer

A
  • Non invasive ductal carcinoma in situ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe what non invasive ductal carcinoma in situ looks like

A
  • premalignant

- micro calcification on mammography (univocal or widespread)

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

describe non invasive lobular carcinoma in situ

A
  • rare

- tends to be multifocal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe invasive lobular carcinoma

A
  • 10-15% of breast cancers

- less common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe who invasive medullary carcinoma affects

A
  • younger patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe who invasive colloid/mucoid carcinoma affected

A
  • elderly patients
20
Q

What is an inflammatory carcinoma

A
  • rare but rapidly progressive form of breast cancer caused by obstruction of lymph drainage causing erythema and oedema
21
Q

How does inflammatory carcinoma present

A
  • progressive
  • erythema and oedema of the breast in the absence of signs of infection such as fever, discharge or elevated WCC and CRP
22
Q

How do you diagnose inflammatory carcinoma

A

CA 15-3 testing positive

23
Q

How many breast cancers are oestrogen receptor positive

A

60-70% of breast cancers are oestrogen receptor positive

24
Q

How many breast cancers express HER2 and what does this mean

A
  • 30% overexposes HER2 associated with poor prognosis and aggressive disease
25
Q

What is the management of early breast cancer (stage1-2)

A
  • Surgery
  • Radiotherapy
  • chemotherapy (6 weeks to act)
  • endocrine Treatment (3 months to act)
26
Q

What surgery is used in early breast cancer (stage1-2)

A
  • removal of tumour by wide local excision or mastectomy and reconstruction
  • also - axillary lymph node sampling/ surgical clearance or sentinel node biopsy
27
Q

What are the complications of surgery for early breast cancer (stage1-2)

A
  • arm lymphedema

- skin necrosis

28
Q

What does radiotherapy do for early breast cancer (stage1-2)

A
  • recommended for all patients with invasive cancer after surgery
  • increases survival and decrease 10 year reoccurrence
  • axillary radiotherapy if lymph nodes are positive and weren’t cleared surgically
29
Q

What are the side effects for radiotherapy in early breast cancer (stage1-2)

A
  • pneumonitis
  • pericarditis
  • rib fractures
30
Q

What mode is chemotherapy used in early breast cancer (stage1-2)

A
  • adjuvant
  • consider in all but excellent prognosis patients
  • neoadjuvant chemotherapy has NO SURVIVAL BENEFITs
31
Q

What chemotherapeutic agents are used in early breast cancer (stage1-2)

A
  • Doxorubicin/epirubicin + CMF ( Cyclophosphamide + methotrexate + 5-FU)
32
Q

How does endocrine treatment work in early breast cancer (stage1-2)

A
  • reduces oestrogen activity and are use din ER+ and PR+ cases
33
Q

What endocrine treatment is used in pre-menopausal women in early breast cancer (stage1-2)

A
  • Anti-oestrogen’s (ER antagonists) such as tamoxifen 20mg/d for 5 years post-op

May also benefit from

  • ovarian ablation (oophorectomy)
  • GnRH analogues - such as goserelin
34
Q

What are the side effects of Anti-oestrogen’s (ER antagonists) such as tamoxifen

A

can lead to uterine cancer

- warn for vaginal bleeding

35
Q

What endocrine treatment is given to post menopausal women in early breast cancer (stage1-2)

A
  • Aromatase inhibitors (target peripheral oestrogen synthesis) such as anastrozole, letrozole and exemestane
36
Q

What is the median overall survival for metastatic breast cancer

A

24 months

37
Q

what is the aim of treatment of metastatic breast cancer

A
  • remission and improved quality and duration of life
38
Q

what treatment is used in metastatic breast cancer

A
  • Tamoxifen (ER antagonist)
  • Chemotherapy if relapse after success of tamoxifen
  • Chemotherapy + biologicals, eg trastuzumab
  • Radiotherapy for painful bony mets and bisphosphonates (supportive)
  • Chest surgery to help wall
  • Psychological care
39
Q

What palliative care is used for breast cancer

A
  • psychological and anxiety
  • pain - analgesia
  • Anorexia - diet and antiemetics
  • constipation - laxatives
  • Metabolic - bisphosphonates
40
Q

What are the prognostic factors for breast cancer

A
  • Tumour size
  • Number of positive axillary nodes
  • Lymphatic and vascular invasion
  • Histological tumour type
  • Histologic grade
  • HER2 overexpression
  • Oestrogen/progesterone receptors HER
41
Q

Name the molecular prognostic factors for breast cancer

A
  • Proliferation index such as Ki67
  • Oncotype – DX 21 gene profile – accepted as being a prognostic factor for ER positive node negative disease
  • Amsterdam 70 gene profile
  • BluePrint 80 gene profile
42
Q

Name the percentage reduction in relative risk of death form breast cancer in adjuvant therapy

A
  • Tamoxifen or anastrozole = 25% reduction
  • Chemotherapy = 20-35% reduction
  • Trastuzumab = 33% reduction
  • Radiotherapy = 5% reduction
43
Q

Name the breast screening programme

A
  • 50-70 year old are tested via mammography every 3 years
44
Q

What new drug is being use in breast cancer

A
  • Trastuzumab - used in HER2 positive patients
45
Q

What are the radiological features of breast cancer?

A
  • irregular shape
  • spiculated margins
  • microcalcifications
  • segmental distribution
  • pleomorphic shape

Year 3 - Met3b (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions