Breast Cancer &genetics Flashcards
most common form of cancer in american women?
breast
breast cancer: Mortality rate has decreased for 1st time in several years, except in __________ _________women where it has increased.
African American
leading cause of death for women age 20-59?
breast cancer
over ___% of breast lumps are benign
80%
fewer than ___ of women follow guidlines for breast cancer screening
1/3
2 biggest risk factors for breast cancer
female, older
who recommends against routine screening mammography in women ages 40 to 49 years? and replacing annual with biennial (every 2 years) screening mammography for women aged 50 to 74 years?
USPTF
ACS screening guideline: asymptomatic age 20-39
breast Self examination: every month
clinical breast examination: every 3 years
ACS screening guideline: asymptomatic age 35-40
Obtain baseline screening mammogram
ACS screening guideline: asymptomatic age 40+
breast self exam: every month
clinical breast exam: annual
mammogram: annual
4 signs of breast cancer
- lump or thickening (breast or axilla)
- change in size or shape of the breast
- Discharge from the nipple (unilateral)
- A change in the color or feel of the skin of the breast, areola, or nipple (dimpled, puckered or dry and scaly)
4 types of imaging for breast cancer
Mammography
Ultrasound
MRI
Large Format Pathology
do you need a physician referral for a mammogram?
NO not if its been a year since the last one
does medicare and medicaid cover annual mammograms?
yes
women with existing breast problems (abnormal screen, lump, nipple discharge, etc), will they get a mammogram screening?
NO this would be a Dx workup
do you need a physician referral for a Dx workup?
YES
for a Dx mammogram/US what must be done?
area of interest/abnormality must be described and located in “clockface” description and given to radiologist so they know where to focus on.
pathology slide of biopsy: red vs blue/black? which is good and which is bad?
red- good
blue/black- bad
an US guided core biopsy is only used if…
Used only if lesion is visualized by ultrasound
-lidocaine administered and tissue samples obtained easily
what is the standard of care for invasive cancer?
sentinel lymph node biopsy
what is a concern post- sentinel lymph node biopsy?
lymphedema
5 txt options for breast cancer
- Surgery
- Chemotherapy – Oncotype DX
- Radiation Therapy
- SERMS/Aromatase Inhibitors
- Targeted Therapy (Biotherapy)
what is oncotype Dx? (maybe weeds)
biopsy and can tell if pt will respond to chemo before starting it
what are the benefits of target therapy for cancer (biotherapy)?
recognizes cancer cells (chemo doesnt) - can give them for as long as they work. (chemo has a limited time for how long you can give it)
what is large format pathology?
whole mastectomy or lumpectomy specimen is on a slide (can see the TRUE circumference of what you took out, wether margins are clear).
what will be done after any mastectomy/lumpectomy?
MRI to be sure enough tissue was taken out
has the re-excision rate increased or decreased over the last few years?
decreased
BRCA1 and BRCA2 mutations are usually present only in ________ cancers. what type of genes are BRCA 1 and BRCA2?
hereditary
- BRCA1 and BRCA 2 are tumor suppressor genes (repaired damaged DNA prior to cell division). mutations in them = cancer
BRCA mutations increase the risk of ____ ______ breast cancer, _____ cancer, and a ______ cancer
early onset breast cancer & ovarian cancer
increase the risk of a second cancer
Increased risk of ovarian cancer following breast cancer
__-fold increase in risk compared to women without mutations
lifetime risk is at least ___%
Increased risk of ovarian cancer following breast cancer
10-fold increase in risk compared to women without mutations
lifetime risk is at least 16%
what cancers (other than breast and ovarian) do BRCA genes increase the risk of?
male breast, prostate, pancreatic
how many women with hereditary risk inherited it from their father?
half of all women
___ ___ _____of breast cancer is more important than the number of women (in your family) with the disease.
age of onset
prophylactic mastectomy for those with BRCA. is total (simple) or subcutaneous more effective? both of these.. do they remove all the breast tissue?
total (simple)
- removes most but not ALL of the breast tissue
what is the “gold standard” of mutation detection? (for hereditary risk)
gene sequencing
