Breast cancer risk assessment and management

Question 1

Risk assessment tool

• Tool
• Components

Answer 1

• Tool
  
  • Gail model
• Components
  
  • Age at menarhce
  • Number of breast biopsies
  • Age at first live birth
  • Number of first degree relatives with breast cancer

Question 2

Screening mammogram recommendation

• General population
• BRCA mutation

Answer 2

• General population
  
  • Baseline at age 35
  • Annual beginning at age 40
• BRCA mutation
  
  • Yearly beginning age 25
• Note:*
• Those with BRCA mutation also needs TVS and CA 125 yearly beginning at age 25

Question 3

Agents for chemoprevention

Answer 3

• Tamoxifen
• Raloxifene

Question 4

BRCA 1 and 2 mutations

• Pattern of inheritance
• Chromosome
• Tumor suppressor or oncogene
• Associated cancer
• Properties of associated cancer
  
  • BRCA 1
  • BRCA 2

Answer 4

• Pattern of inheritance
  
  • Both AD
• Chromosome
  
  • BRCA 1 – Chr 17
  • BRCA 2 – Chr 13
• Tumor suppressor or oncogene
  
  • Both are tumor suppressors
• Associated cancer
  
  • BRCA 1
    
    • Breast and ovarian
  • BRCA 2
    
    • Breast in both men and women
• Properties of associated cancer
  
  • BRCA 1
    
    • poorly differentiated and hormone receptor negative
  • BRCA 2
    
    • well differentiated and hormone receptor positive

Question 5

Lifetime risk for breast CA if with BRCA mutation

Answer 5

• BRCA 1 – 90%
• BRCA 2 – 85%