Breast Carcinoma - Background

Question 1

lifetime risk for women in UK is 1 in ?

5% related to ?/? genes, 40% are detected on ?

Answer 1

8
BRCA1/2
screening

Question 2

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.

Answer 2

invasive adenoca
invasive ductal
invasive lobular
in-situ
oestrogen
better
HER2 and progesterone
HER2

Question 3

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.

Answer 3

spread
ductal
eczematous x2
biopsied

tethering
retraction
pectoral
fixation

Question 4

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).

Answer 4

block
peau d'orange
axilla
clavicular
bone
fractures
calc
lung
krukenburg

Question 5

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.

Answer 5

BRCA
environmental
oestrogen
smoking

Question 6

RF’s
regarding oestrogen exposure:

? menarche/ ? menopause.
? {or late age of first ?).
Not ?.
???.
Obesity.

Answer 6

early
late
nulliparity
child
breastfeeding
HRT

Question 7

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 ?).

Answer 7

triple
ex
imaging
uss
35
cystic
solid

Question 8

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 ?

Answer 8

mammography
dense
spiculated
microcalcification
fnac
core
grading

Question 9

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.

Answer 9

2
2-5
5
fixed
chest
peau d'orange
no
ipsilateral
fixed
liver
cxr
bone