Breast carcinoma

Question 1

How common is it?

Answer 1

50,000 new cases diagnosed each year in the UK, quarter come through mammography screening

Question 2

Who does it affect?

Answer 2

200 times more likely in females

Question 3

Risk factors?

Answer 3

Family history and increasing age. 
Alcoholic drinks. 
Diethylstilboestrol. 
Oestrogen-progesterone contraceptives
HRT
X-ray radiation and gamma-radiation. 
Body fatness
Adult attained height. 
Breastfeeding reduces the risk. 
BRACA 1 and 2. 
Basically more oestrogen is bad. 
Early menarche, shorter or longer cycles. 
If they have their first baby above the age of 30.

Question 4

How does it present?

Answer 4

Breast lump is the most common presentation, a malignant breast lump is usually painless, but pain can occur. Nipple symptoms, including change in shape or nipple bleeding, are recognised symptoms as are skin changes, such as tethering or peau d’orange.

Question 5

Investigations?

Answer 5

Triple assessment: imaging, FNA or biopsy and clinical examination.

Question 6

Treatment?

Answer 6

Excision, wide local or mastectomy. Followed by chemo and/or radiotherapy. Tamoxifen for 5 years after which competitively competes with oestrogen for binding to the ER in breast tissue. You may be given aromatase inhibitors instead which block the production of oestrogen.

Question 7

Differential?

Answer 7

Fibroadenoma