Breast Cancer

Question 1

Breast Cancer Screening Programme

Answer 1

all women aged 50 to 71 who are registered with a GP get invited for a mammogram every 3 years

Question 2

who develops breast cancer

Answer 2

1 in 8 women develop breast cancer
0.8% male
Mainly between 50-71

Question 3

risk factors for breast cancer

Answer 3

oestrogen exposure over lifetime - early menopause, late menopause, later age of pregnancy, no pregnancy,  HRT.
hereditary syndrome (BRCA mutation)

Question 4

most common type of breast cancer

Answer 4

adenocarcinoma derived from epithelial tissue from lobules or ducts

Question 5

lobular carcinoma in situ

Ductal carcinoma in situ

Answer 5

high grade dysplasia in the lobules/ducts called

earliest stage, not yet malignant

Question 6

what are invasive carcinomas that develop in the lobules/ducts called

Answer 6

lobular / ductal carcinomas

Question 7

Aetiology of breast cancer

Answer 7

uncontrolled growth of epithelial cells in the breast

Question 8

main parts of the breast

Answer 8

Glandular tissue
stroma (adipose)
lymphatic vessles

Question 9

describe glandular tissue of the breast

Answer 9

made up of 15-20 lobules
inside each lobule is alveoli (modified sweat glands)
these alveolar cells secrete milk

Question 10

how does milk pass through the breast

Answer 10

alveolar cells produce milk
myoepithelial cells squeeze and push the milk out of the lumen, into the lactiferous duct and out one of the pores on the nipple

Question 11

coopers ligerments

Answer 11

suspensory ligaments that run through the stroma and help keep it in place

Question 12

blood supply of the breast

Answer 12

laterally axillary

medially - internal thoracic artery

Question 13

lymphatic drainage of the breast

Answer 13

mainly axillary lymph nodes but also mammary chain

Question 14

which hormones cause alveolar cells to divide and increase in number

Answer 14

oestrogen, progesterone, prolactin

Question 15

genes that can cause increased risk of breast cancer if mutated

Answer 15

BRCA 1/2 and TP53, HER 2

Question 16

paget disease of the nipple

Answer 16

cancerous cells from a DCIS migrate along the lactiferous duct, through the pore and onti the skin of the nipple. The cancer cells secrete mobility factor which allows them to get between the epithelial cells. this causes inflammation, which brings extracellular fluid out through pores in the nipple, which dries and forms a crust

Question 17

natural progression of LCIS

Answer 17

clusters of tumour cells grow within the lobules. less common than DCIS. this causes alveoli to enlarge. doesnt invade

Question 18

3 types of breast cancer (hormone)

Answer 18

oestrogen receptor (ER positive and HER2 negative), most common
HER2 positive and ER negative
HER2, ER neg

Question 19

complications of breast cancer

Answer 19

tumour causes local inflammation, damaging the suspensory ligaments and lactiferus ducts and causing fibrosis
invades nearby tissues (like pec muscles or skin)
block lymph,which causes lymph build up in interstitial space and causes the skin to dimple
mets - bone, lung, brain

Question 20

symptoms of breast cancer

Answer 20

hard painless lump (lateral upper quadrant)
dimpling of skin (lymph)
Retraction of the nipples (fibrosis)
crusting, itchy, discharge of the nipples (pagets disease)