Breast Week general Flashcards
what percentage of breast cancers are male
0.6-1%
peak age of male breast cancer
75
is gynecomastia associated with male breast cancer
no
male breast cancer presentation
- lump (75%)
- early nipple involvement
- very rarely Paget’s
do men get lobular breast cancer
no, because lobules and acini are not found in normal male breast tissue.
male breast cancer surgery
mastectomy
what is most commonly used for male breast cancer endocrine therapy
tamoxifen
gynaecomastia treatment
- correct underlying cause or drug
- medical treatment e.g. tamoxifen
- surgical treatment if failure of others options, psychological complications
what is the most common benign growth in the breast
fibroadenoma
true or false, fibroadenomas are highly mobile
true
do fibroadenomas need to be removed
no
do phyllodes tumours need to be removed? explain your answer
yes because around 1/3 of Phyllodes tumours havemalignant potential
what is a hamartoma (fibroadenolipoma)
Circumscribed lesion composed of cell types normal to the breast but present in an abnormal proportion or distribution
what is a radial scar
a growth that looks like a scar when the tissue is viewed under a microscope. It has a central core containing benign ducts. Growing out of this core are ducts and lobules that show evidence of unusual changes such as cysts and epithelial hyperplasia (overgrowth of their inner lining)
what is an intraduct papilloma
Benign breast lesion
who does an intraduct papilloma typically affect
females in their 40-50yrs
where does an intraduct papilloma most typically occur
thesubareolar region
intraduct papilloma presentation
clear or bloody nipple discharge
asymptomatic
what is a lipoma
Soft and mobilebenign adipose tumour that are normally otherwise asymptomatic
does a lipoma need removed - explain your answer
not usually - low malignant potentialand are usually only removed if they are significantly enlarging or causing symptomatic compressive or aesthetic issues
mastitis management
flucloxacillin 500mg orally every 6 hours for 7 days
or augmentin 625mg every 8hrs for 7 days
what does a breast abscess most commonly develop from
acute mastitis
describe a breast cyst on examination
typically palpable, clearly defined, soft, mobile, and smooth, with distinct borders
often somewhat tender
how can a breast cyst be identified on mammography
halo shape
what is duct ectasia
dilation and shortening of the major lactiferous ducts
what % of women having significant duct dilatation by 70 yrs
40%
duct ectasia is associated with smoking, true or false
true
what is mammoplasty
breast reduction
neoadjuvant meaning
prior to surgery
adjuvant meaning
after surgery
NACT meaning
neoadjuvant chemotherapy
risks of anthracyclines chemotherapy
- affect heart, small risk of leukaemia
usually course of chemotherapy
Usually total of 6 to 8 cycles, at 3 weekly intervals
treatment of neutropenic sepsis (complication of chemo)
IV Tazocin
indications for NACT
- inflammatory breast cancer
- downstaging required e.g. huge nodal burden
- T2 (at least 2cm) - if HER2 positive/Triple negative
- Tany N 1 or above - if HER2 positive/Triple negative
how often are bloods checked in neoadjuvant chemotherapy
prior to administration of each cycle (usually neuts need to be >1and platelets >100)
indication for adjuvant chemotherapy
- Usually if Her2 positive/triple negative who have NOT got chemotherapy neoadjuvantly
- Node positive premenopausal patients (ER positive)
- NHS PREDICT score – 3-5% get Oncotype
cancer driven by hormones - more or less sensitive to chemo?
less
name two drugs you can NOT use in the adjuvant setting
carboplatin
pembrolizumab
after adjuvant chemotherapy, wait ______ weeks, then commence _______ and ______ treatment
3-4
radiotherapy
endocrine (hormone)
mainstay of drug treatment for endocrine treatment
Tamoxifen and Letrozole
is letrozole used as endocrine treatment pre or post menopausal
post
what does tamoxifen do (what is the mechansim)
ANTAgnosies the oestrogen receptors around breast tissue
AGONISTIC around Uterus, hence small risk of uterine cancer
letrozole mechanism
essentially stops fat cells from producing oestrogen (this is why it’s not used premenopausal because the ovaries would just bypass this)
how long is hormone treatment given for
generally 5 years
can extend to 10 years if high risk
in oestrogen driven breast cancer, are HRT and hormonal contraception recommended or contraindicated
contraindicated
when is radiotherapy used in breast cancer
after breast conservation
after mastectomy if 4 or more nodes involved and/or T3-T4 tumours
how many radiotherapy treatments are given
Usually 5 treatments to the breast/chest wall or 15 treatments if lymphatics involved.
