Breast Surgery: Cancer Flashcards
what are ductal carcinoma and lobular carcinoma
Ductal Carcinoma: a malignant change within the cells which line the milk ducts of the breast.
Lobular Carcinoma: a malignant change within the secretory glands of the breast (the lobule)
can be further classified as in-situ or invasive
what is the most common type of breast cancer
invasive ductal carcinoma
who is offered breast screening
47-73 year olds
every three years
risk factors for breast cancer
Increasing age.
A personal history of breast conditions or breast cancer.
A family history of breast cancer. BRCA1 and BRCA2.
Obesity.
Early menarche, late menopause, null-parity, or late (older than 30) first pregnancy
Postmenopausal hormone therapy. Risk decreases after stopping medication.
presentation of breast cancer
Lump in the breast or armpit (less likely to be firm or distinct if lobular)
Thickening/redness, swelling or change in the shape
Localised persistent breast pain
Dimpling or retraction of the skin of the breast or the nipple, (circumferential retraction of the nipple is associated with IDC)
Discharge
Scaly or flaky skin on the nipple or an ulceration (sore) on the skin of the breast or nipple. These can be signs of Paget’s disease, a different kind of breast cancer that can occur along with IDC.
what three components make up triple assessment
Clinical examination
Imaging: Mammogram, or USS or both
Core biopsy +/- Fine needle aspiration cytology
why is age important when deciding between mammograms and USS
people under 40 are generally not offered mammograms as they have a higher density of breast tissue, this causes a stronger white signal across the whole breast which would hide any sign of malignancy
when would CT be used for breast cancer
CT generally isn’t used for diagnosis of malignant breast disease however in confirmed diagnosis can be used for screening for metastatic areas
what grading system can be used for breast cancer
Gleasons scoring
what is gleasons grading based on
Grading considers the amount of pleomorphic, tubule formation and mitotic rate
used in glandular tissue
if the primary treatment is wide local excision of the malignancy what oncological treatments would also be appropriate
Neoadjuvant chemotherapy is often used during breast conserving treatment
Radiotherapy is also very often used post surgery, especially if there was node involvement
what is the alternative name of lumpectomy
wide local excision
generally used for smaller tumours which are in the appropriate place to be removed on their own
what are the different endocrine based treatments dependent on menopausal status
pre-menopausal: Tamoxifen
post-menopausal: Anastrozole and Exemestane
what drugs can be used for endocrine treatment in post menopausal women
Anastrozole and Exemestane
how do Anastrozole and Exemestane work
They are aromatase inhibitors which mean they block the production of oestrogen. This can’t be given to premenopausal women as it would induce menopause.
