Breast Carcinoma

Question 1

What is it?

Answer 1

Cancer of the Breast tissue

Question 2

Is there a pre-malignant phase?

Answer 2

Yes, Ductal Carcinoma In Situ which is seen as microcalcification on mammography

Question 3

What is the most common type of Breast Carcinoma?

Answer 3

Invasive Ductal Carcinoma causes 70%

Question 4

Other types of Carcinoma (5)

Answer 4

Invasive Lobular, Medullary, Colloid, Mucoid, Paget’s

Question 5

Which are the least aggressive types?

Answer 5

Oestrogen Receptor Positive Cancers, 60%

Question 6

Which are the most aggressive?

Answer 6

Cancers that express HER 2 (a growth factor receptor)

Question 7

Is it common?

Answer 7

Yes, it affects 1 in 9 women

Question 8

Does it happen in men?

Answer 8

Yes but it is not common, only 1% of cases are male

Question 9

Risk Factors (8)

Answer 9

Family History, Age, Nulliparity, Early Menarche, Late Menopause, HRT, BRCA 1&2 genes, previous breast cancer

Question 10

Investigations (3)

Answer 10

Triple Assessment: Breast Exam, Mammogram, Fine Needle Aspiration

Question 11

What staging does breast cancer use?

Answer 11

TNM

Question 12

What is Stage 1?

Answer 12

Confined to the breast

Question 13

Stage 2?

Answer 13

Growth is confined to the breast but there is ipsilateral lymph node involvement in the Axilla

Question 14

Stage 3?

Answer 14

Tumour is fixed to muscle, there are ipsilateral nodes and skin involvement

Question 15

Stage 4?

Answer 15

Complete fixation of the tumour to the chest wall and there are distant metastases

Question 16

Treatment for Stages 1 & 2 (6)

Answer 16

Tumour excision, mastectomy, radiotherapy, chemotherapy
Trastuzumab is Herceptin for HER 2 tumours
Tamoxifen is an oestrogen blocker for Oestrogen receptive tumours

Question 17

Treatment for Stages 3&4 (2)

Answer 17

Radiotherapy for bone lesions, chemotherapy

Question 18

How can we prevent it?

Answer 18

Screening programmes using Mammography and promoting awareness