Breast cancer (Breast lecture 4) Flashcards
How does breast cancer usually present?
Lump Mastalgia Nipple discharge Paget's disease Nipple retraction Change in size/shape of breast Lymphoedema Dimpling of breast skin
What are some risk factors more specifically associated with breast cancer?
Previous breast cancer BRCA1 BRCA2 Early menarche Late menopause Late or no pregnancy HRT Post radiotherapy hodgkins treatment
What are the 3 components of the one-stop-shop for breast screening?
Clinical
Radiological (mammogram, USS)
Cyto-pathological (FNA cytology, core biopsy)
Why is breast imaging less sensitive in younger women?
Presence of increased glandular tissue (<35yrs)
What does core biopsy test for?
Invasive vs in situ
ER, PR, HER2 receptor status
What is the most sensitive test for breast disease?
FNA cytology
What are the main tests for assessing severity of breast disease?
FBC U&Es LFTs Ca2+/Po2- CXR
What are the main components of breast cancer treatment?
Surgery
Radiotherapy
Chemotherapy
Hormonal therapy
What is the significance of the sentinel lymph node?
Common biopsy site
First node to receive lymphatic drainage
First node the tumour spreads to
If negative, rest of nodes in lymphatic basin are negative
What are some possible complications of axillary treatment?
Lymphoedema Sensory disturbance Decreased shoulder joint ROM Nerve damage Vascular damage Radiation induced sarcoma
Which nerve is usually affected in sensory disturbance following axillary treatment?
Intercostobrachial nerve
What are some factors associated with increased risk of disease recurrence?
Lymph node involvement Tumour grade Tumour size Steroid receptor status (negativity- ER/PR neg) HER2 status (positivity- HER2 pos) LVI- lymphovascular invasion
List some possible complications following radiotherapy?
Skin reaction- Skin telangiectasis
Radiation pneumonitis
Cutaneous Radionecrosis/ Osteonecrosis
Angiosarcoma
What is the aim of hormone therapy for breast disease?
Blocks stimulation of cell growth by oestrogen
Which medications are used in hormone therapy for breast disease?
Tamoxifen Aromatase inhibitors (Arimidex, Letrozole)
