Breast Disease

Question 1

Important questions on family history for breast cancer

Answer 1

Male breast cancer
materal vs. paternal
bilateral breast cancer?

Question 2

other cancers that matter?

Answer 2

Prostate: BRCA2
Ovarian: BRCA1
Familial gastric cancer

Question 3

what race/population more at risk of breast cancer?

Answer 3

Eastern Europe Jewish population ashkenazi

Question 4

why is breast cancer less risk with breast tissue?

Answer 4

exposure to estrogen and pregnant makes breast tissue more differentiated, less likely to be become malignant

Question 5

2 physiological conditions that cause more estrogen.

Answer 5

pregnancy

obesity

Question 6

2 conclusions at end of examination

Answer 6

normal

not sure if malignant

Question 7

breast screening ages in Australia?

Answer 7

50-75 mammography every 2 years

Question 8

Investigations for a 37 year old, and found a lump?

Answer 8

Ultrasound

Mammogram

Question 9

likely dx for a young female who finds a lump

Answer 9

Cyst
fibroadenoma
area of fibrocystic changes

Question 10

aspirating a cyst, dangerous when fluid is?

Answer 10

if cyst fluid is bloody

Question 11

types of biopsy?

Answer 11

incisional
excision
FNA
Core
'liquid' (not available yet)

Question 12

breast cancer metastasize most common place first?

Answer 12

bone»lung»liver»brain

Question 13

bone scans for staging for breast cancer?

Answer 13

usually not if they are asymptomatic

Question 14

5 treatments for breast cancer?

Answer 14

biologics
surgery
endocrine therapies (selective estrogen antagonists)
radiotherapy
chemotherapies

Question 15

why mastectomy if someone is BRCA carrier?

Answer 15

risk of a new primary

Question 16

don’t want to irradiate if what condition?

Answer 16

scleroderma

Question 17

why won’t you irradiate someone?

Answer 17

if they’ve had radiation before in the area

Question 18

role of axillary surgery?

Answer 18

1. to biopsy it and prognosis
2. guiding management
3. prevent spread (local control)
4. treat spread

Question 19

sentinel node hypthesis

Answer 19

that drainage of a certain area must go through this node

Question 20

more info for breast cancer after excision?

Answer 20

endocrine sensitive?
HER2 amplification
immunohistochemistry

Question 21

if over 35, and planning to have a family? what will be problems?

Answer 21

fertility: hemo, rad, herceptin will affect

Ovum and embryo stored

Question 22

chemo do what to ovaries?

Answer 22

induces menopause

Question 23

if wants preg and still on therapy?

Answer 23

need hiatus in endocrine treatment, usually 5-10 years

Question 24

Best lifestyle things to prevent reoccurrence?

Answer 24

exercise and no smoking

Question 25

When is young age of breast cancer?

Answer 25

under 50

particularly under 40