Breast cancer Flashcards
how would you decide between a WLE or mastectomy for the treatment of breast cancer ?
WLE
- solitary lesion
- small lump in a large breast
- peripheral
- DCIS < 5cm
mastectomy
- multifocal tumour
- large lump in a small breast
- central
- DCIS > 5cm
when would you give radiotherapy in the management of breast cancer?
adjuvant after WLE
adjuvant after mastectomy if stage 3 or 4 or if 4 or more positive axillary node involvement
what hormonal therapy are used in treatment of breast cancer ?
if ER positive
- tamoxifen
- aromatase inhibitors i.e. anastrozole if post menopausal
(this is because majority of oestrogen is produced by aromatisation after the menopause)
what is the most common type of breast cancer?
invasive ductal carcinoma
what’s the difference between invasive and carcinoma in situ?
CIS doesn’t invade local structures but invasive carcinoma does
when would you refer a patient for suspected breast cancer ?
cancer referral pathway (appointment within 2 weeks)
refer if ;
> 30yrs with breast lump
> 50yrs with unilateral nipple symptom i.e. discharge, retraction, skin change
consider referral if;
>35 yrs with axillary lymphadenopathy
any age with skin changes suggestive of cancer
consider non urgent referral for < 30yrs with unexplained breast lump
what are risk factors for breast cancer ?
BRCA 1, BRCA 2 P53 mutation obesity early menarche, late menopause OCP, combined HRT previous breast cancer radiation to the chest nuliparity, 1st pregnancy > 30yrs 1st degree relative < 30yrs with breast cancer
when is screening for breast cancer carried out?
every 3 years from 50 -70yrs
what treatment is given for HER2 positive breast cancer?
herceptin (tratzumab)
what treatment is given for ER positive breast cancer?
tamoxifen
aromatase inhibitors e.g. anastrozole (post-menopausal)
