Breast Cancer Flashcards
What is the triple assessment for breast cancer?
1) Breast examination
2) Imaging - US/mammography (XR)
3) Core biopsy (histology/cytology)
How do you diagnose breast cancer?
Biopsy
What targeted treatment can you use if a pt is HER2 positive?
Herceptin (trastuzumab) ± pertuzumab
What % of breast cancer patients are HER2 positive?
30%
What targeted hormone therapy can you use if a pt is ER/PR positive?
- Tamoxifen - premenopausal women
- Aromatase inhibitors (anastrozole + letrozole) - postmenopausal women
What type of medication is tamoxifen?
Selective Oestrogen Receptor Modulator (SERM)
What do aromatase inhibitors do?
Reduce peripheral oestrogen synthesis
What imaging do you do for staging breast cancer?
- MRI
- PET-CT
- FDG-PET
What other investigation can you do in breast cancer?
Genetic tests
What is a common treatment-related complication of breast cancer?
Lymphoedema - swollen arm
How do you curatively treat breast cancer?
- Surgery - WLE (wide local excision)/mastectomy
- Radio - adjuvant
- Chemo - Neo/adjuvant - anthracycline
± Targeted herceptin (HER2+)/hormone therapy (PR/ER_)
Is hormone therapy adjuvant or neoadjuvant?
Adjuvant
What might be the only sign present in early breast cancer?
Breast/axillary mass/lump (otherwise asymptomatic)
What are breast symptoms in breast cancer?
- Skin changes - puckering/deformity/dimpling, erythema, peau d’orange, nipple ulcer/eczema
- Nipple changes - discharge, inversion
What are risk factors for breast cancer?
- Early menarche/late menopause
- HRT/COCP
- Nulliparity
- Genetics (BRCA, TP53)
- FH
- Alcohol, obesity
- XR, RT
- Not breast feeding
- Caucasian
