breast cancer

Question 1

definition of breast cancer?

what is the most common type?

Answer 1

• malignancy of breast tissue

- invasive ductal carcinoma

Question 2

risk factors of breast cancer?

Answer 2

• age
• family history
• obesity
• oestrogen exposure
  (early menarche, late menopause, HRT/OCP)
• fatty diet
• radiation to chest
• nulliparity
• BRCA

Question 3

epidemiology of breast cancer?

Answer 3

• the most common cancer in the UK

- 1/7 females in the UK will be diagnosed with breast cancer in a lifetime

Question 4

presenting symptoms of breast cancer?

shown with examination?

Answer 4

• increase in the size of the breast
• lump
• skin changes
• inflammatory breast

Question 5

characteristics of breast cancer lump

Answer 5

• hard lump
• irregular margins
• non-compressible
• fixed
• generally painless

Question 6

what skin changes might be present?

Answer 6

• armpit skin thickening
• peau d’orange
• skin dimpling
• nipple discharge
• nipple inversion
• eczematous-looking skin (Paget’s)

Question 7

what are the symptoms of metastases?

Answer 7

bone pain, shortness of breath, rarely

neurological symptoms

Question 8

what is the first stage management for a breast lump?

Answer 8

triple assessment: 
- clinical examination 
- imaging
>35 mammorgam 
<35 USS 
- tissue diagnosis 
FNA or core biopsy

Question 9

treatment for a breast lump?

Answer 9

• surgery
  mastectomy
  lumpectomy with radiotherapy
  Sentinel LN biopsy or axillary LN clearance
• medications
  ER antagonists e.g tamoxifen
  Aromatase inhibitors e.g letrozole
• Chemotherapy
  Neo-adjuvant or adjuvant
• Monoclonal antibodies
• Radiotherapy

Question 10

how is breast cancer staged?

Answer 10

• Nottingham grading system
• TNM is used
• Tumour
• Nodes
• Metastases

Question 11

what are examples of invasive and non-invasive breast cancer?

Answer 11

Non-invasive: DCIS

Invasive: infiltrative ductal carcinoma (75%), infiltrative lobular carcinoma,
Paget’s disease of the breast