Breast Carcinoma - Background Flashcards
lifetime risk for women in UK is 1 in ?
5% related to ?/? genes, 40% are detected on ?
8
BRCA1/2
screening
Morphology;
- Most tumours are ? ?, of which 90% are ? ? carcinoma, and 5% are ? ? carcinoma (5% lobular/ductal ?).
Carcinoma of the breast can either be ? receptor (ER) positive or negative, and ER positive carcinomas confer a ? prognosis.
The ? and ? receptors are also therapeutic targets.
o ? positive tumours carry a poorer prognosis however.
invasive adenoca invasive ductal invasive lobular in-situ oestrogen better HER2 and progesterone HER2
Pathological consequences;
Paget’s disease of the nipple;
o ? of intra-? carcinoma of the breast, leading to ? changes around the nipple. Any ? rash on the breast should thus raise suspicion of this diagnosis, and be ?.
Local spread;
o Into overlying skin to produce ? of the skin / nipple ?.
o Into the ? muscles to cause deep ? of the tumour.
spread
ductal
eczematous x2
biopsied
tethering
retraction
pectoral
fixation
Pathological consequences;
Lymphatic spread;
o Can ? lymphatic drainage, to give a ? ? appearance.
o Nodes in the ? are frequently involved, as well as ? nodes.
Vascular spread;
o Distal dissemination is most commonly to the ? (pathological ? and hyper?).
o Other sites are the ?, and the ovary {? tumour).
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RF’s
Genetic factors {PH, FH, ? positive) make up 25% of the risk, with ? factors making up the remaining 75%. Environmental factors are mainly to do with
increased ? exposure.
? is also a risk factor.
BRCA
environmental
oestrogen
smoking
RF’s
regarding oestrogen exposure:
? menarche/ ? menopause.
? {or late age of first ?).
Not ?.
???.
Obesity.
early late nulliparity child breastfeeding HRT
Dx
? Assessment is the gold-standard for every breast lump;
Clinical ?.
Breast ? {generally all will have ?, plus mammography if >?).
Cytology (FNAC if ?, core biopsy if ?).
triple ex imaging uss 35 cystic solid
Dx
? is less sensitive in women under 35 as the breast tissue is much more ?
A typical carcinoma appears as a ? mass lesion, with associated ?
? cannot distinguish between in-situ and invasive cancers, whereas ? biopsies preserve the tissue architecture so invasion can be determined along with ?
mammography dense spiculated microcalcification fnac core grading
Staging
TNM;
Tl ?cm, T4 = ? to ? wall or ? ?.
NO= ? nodes, Nl = mobile ? nodes, N2 = ? nodes.
MO= no distant metastases, Ml= distant metastases.
If metastases are suspected, patients will have a ? USS, ? & ? scan.
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