Breast Tumours Flashcards
What is the screening age in Scotland?
50-70
Is having your first child at an older age protective against or a risk factor for ovarian cancer?
Risk factor for
A younger age of menarche and older age of menopause are both risk factors for breast cancer. True or false?
True
Multiparity and breastfeeding are both risk factors for breast cancer. True or false?
False - nulliparity is a risk factor and breast feeding is protective
Is the OCP protective against or a risk factor for ovarian cancer?
Risk factor
What is the most common type of breast cancer?
Ductal carcinoma
What is a ductal carcinoma in situ?
Cytologically malignant epithelial cells but non-invasive (confined within basement membrane). A non–obligate but true precursor of invasive carcinoma
What is atypical ductal hyperplasia?
A precursor lesion associated with an increased risk of ductal carcinoma
What is atypical lobular hyperplasia?
<50% of lobule involved and increased risk of lobular carcinoma
What is lobular carcinoma in situ?
> 50% of lobule involved. Malignant but non-invasive (confined within basement membrane). Non-obligate precursor of invasive lobular carcinoma
When does a precursor lesion become invasive breast carcinoma?
When it has breached the basement membrane and infiltrated normal tissue
What are the 3 main hormone receptors expressed in breast cancer?
- Oestrogen receptor (ER) - 80% ER positive
- Progesterone receptor (PR) - 67% PgR positive
- HER2 - 14% HER2 positive
What is the best imaging technique for women <40 vs women >40 in breast cancer?
<40 = uss >40 = mammogram
When should radiotherapy be used in breast cancer?
o As part of breast conserving surgery or
o After mastectomy if involvement of more than three nodes, positive surgical margins and/or tumors larger than 5 cm or
o Palliative
When should hormone therapy or chemotherapy not be used in breast cancer?
Not given in low grade with good prognosis
What anti-oestrogen therapy should be given in pre- vs post-menopausal women with breast cancer
Pre-menopausal = Tamoxifen
Post-menopausal = aromatase inhibitors (letrozole, anastrozole) or
What is paget’s disease of the nipple?
High grade DCIS extending along ducts to reach the epidermis of the nipple
What are the main side effects of tamoxifen?
Thromboemolic events & endometrial hyperplasia (+ hot flushes and joint pain)
What is the main side effect of aromatase inhibitors?
Osteoperosis (+ hot flushes and joint pain for all hormonal therapy)
Breast cancer is the commonest cancer in women. True or false?
True
Breast cancer is the commonest cause of death from cancer in women. True or false?
False - it is the second commonest (lung is the most common)
What is the screening age for breast cancer?
50-70 (every 3 years)
What does radiotherapy given postoperatively do?
Reduces risk of recurrence
What medication can help with bony mets?
Bisphosphonates
What medication is used if a tumour is HER2 +ve
Trastuzumab
