Breast Treatment

Question 1

ER+ premenopausal

Answer 1

Tamoxifen ± GnRH analogue

Question 2

ER+ postmenopausal

Answer 2

Aromatase inhibitor (zole)

Question 3

HER2+ (any age) Tx

Answer 3

Add trastuzumab (Herceptin) to chemo

C= Cardiotoxicity

Question 4

Triple negative Tx

Answer 4

Pembrolizumab + Chemotherapy

Question 5

Small, localised tumour

Answer 5

Lumpectomy + Radiotherapy

Question 6

TamoxifEn (SERM), what risk (2)?

Tx for ER positive premenopausal

Answer 6

thromboembolic risk

endometrial cancer

Question 7

Aromatase inhibitors (zOle) what risk?

Answer 7

bone thinning risk

Question 8

Trastuzumab

(Tx HER2-positive)

(HerCeptin) what risk?

Answer 8

cardiotoxicity

Question 9

Aromatase Inhibitors (Letrozole, Anastrozole) MOA

Answer 9

Blocks aromatase enzyme → ↓ peripheral estrogen production

Question 10

GnRH analogues (e.g. goserelin) MOA

Answer 10

Suppresses FSH/LH → decreases oestrogen

Question 11

Trastuzumab (Herceptin) MOA

(Tx HER2 Positive)

Answer 11

Monoclonal antibody targets HER2 receptor

Question 12

Chemotherapy (e.g. FEC-T) MOA

Answer 12

Cytotoxic to rapidly dividing cells

Question 13

Radiotherapy MOA

Answer 13

DNA damage to residual cancer cells

Question 14

Cyclical Mastalgia (3)

Answer 14

⏳ Worse before period

👩‍🦰 Premenopausal women

🔄 Bilateral, dull, heavy pain

Question 15

Duct Esctasia (3)

Women > 50

Answer 15

Green, brown or cheesy discharge

painful

BILATERAL

Question 16

Intraductal Papilloma (2)

Women 30>50

Answer 16

Bloody discharge

Painless

Question 17

persistent lump breast lump

Referral pathway

Answer 17

≥30 years: Urgent referral (2-week wait) for a persistent lump.

<30 years:

First-line imaging is ultrasound.

Urgent referral for suspicious features (e.g., irregular margins, rapid growth).

Key Point: Ultrasound is preferred for women <40 years; mammography is used less often due to dense breasts.

Question 18

Breast Cancer screening in UK age?

Answer 18

55