Breast Cancer and Reconstruction Flashcards
What are the precursor lesions for breast carcinoma?
DCIS (ductal carcinoma in situ)
LCIS (lobular carcinoma in situ) - much less common than DCIS
confined within basement membrane
When does DCIS become carcinoma?
when malignant epithelial cells breach the basement membrane
What are risk factors for developing breast cancer?
nulliparity early menarche, late menopause HRT obesity BRCA not breastfeeding PMHx breast cancer Fix breast cancer
What is stage 1 breast carcinoma?
confined to breast, mobile
What is stage 2 breast carcinoma?
growth confined to breast
mobile
nodes in ipsilateral axilla
What is stage 3 carcinoma?
tumour fixed to pec major
ipsilateral nodes fixed
skin involvement
What is stage 4 carcinoma?
complete fixation of tumour to chest wall, distant mets
How does breast cancer present?
calcification on Mx lump nipple inversion skin changes e.g. peau d'orange nipple discharge fixing of breast to pec major tethering of mass to skin
How are breast lumps investigated?
triple assessment
What are the most common types of breast carcinoma?
ductal - 70%
lobular - 10%
What hormone receptors can breast cancers express?
ER
PR
HER2
If a breast cancer expresses HER2, is there a better or worse prognosis?
worse
What drug can be used in HER2 positive cancers?
herceptin - trastuzumab
What drugs can be used in ER positive cancers?
ER blocker - tamoxifen
aromatase inhibitor - anastrozole
Why can aromatase inhibitors only be used in post menopausal women?
as they reduce peripheral oestrogen concentration - so early menopause
