Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cancer Y2 > Cancer as a Disease - Breast Cancer > Flashcards

Cancer as a Disease - Breast Cancer Flashcards

1
Q

Three things that need to occur before oncologists can diagnose breast cancer

A

 Consultation and clinical examination
 Mammography
 Core needle biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Leading cause of female cancer?

A

Breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

% of women that will develop breast cancer in life

A

12.5% , 1 in 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Breast cancer incidence change over time?

A

Been increasing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Breast cancer mortality change over time?

A

Falling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Reasons for breast cancer mortality fall ? (3)

A

early diagnosis, chemo/radiotherapies, hormonal therapies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

X gland is the only one which develops post-Nataly

A

mammary glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What signals mammary gland growth

A

Puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  • The breast is a fatty organ with a X which comes together at the nipple
A

Ductal network

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Around the ductal network of the breast is X

A

Fatty stroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

the vast majority of breast cancers are …

A

carcinomas of the epithelial cells of the ductal network

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many epithelial tissue layers are there in the breast? What are they called?

A

2 layers of epithelial cells An inner layer of luminal epithelial cells and a second layer of myoepithlial cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Purpose of the myoepithelial cells?

A

can constrict/contract and are important to the development of the mammary gland, this helps move milk to the nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most types of breast cancer arise from which layer of epithelium?

A
  • Most types of breast cancer arise from the luminal epithelial cells, but some are myoepithelial and they are more difficult to treat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which type of epithelium has oestrogen receptors

A

Luminal epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the progression from a normal to malignant breast (KW: benign in situ carcinoma, lobular, medullary)

A
  • Local proliferation of luminal cells occurs without breaking away from the tube and without loss of the myoepithelial cells
  • This is benign in situ carcinoma – this is not dangerous and there’s no intervention, it’s a watching and waiting kind of situation
  • We believe this is a precursor state for the development of cancer/tumour cells
  • From benign in situ carcinoma we can get lobular carcinoma (cells retain some ability to behave normally, they adopt a tubular arrangement but there are no more myoepithelial cells ) or medullary carcinoma (cells are very different to normal epithelial cells)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 2 things can a benign in situ carcinoma develop into

A

lobular carcinoma (cells retain some ability to behave normally, they adopt a tubular arrangement but there are no more myoepithelial cells ) or medullary carcinoma (cells are very different to normal epithelial cells)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is a lobular carcinoma

A

cells retain some ability to behave normally, they adopt a tubular arrangement but there are no more myoepithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a medullary carcinoma

A

cells are very different to normal epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

XXX many of which feature no special type of histological structure, account for almost 80% of breast cancers

A
  • Infiltrating ductal carcinoma (IDC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Example of a biomarker test for breast cancer

A
  • Oestrogen Receptor test is a biomarker test that is super useful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
  • About 80% of breast cancers are XXX, these are the ones that grow in response to oestrogen
A

oestrogen-receptor positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

BREAST CANCER GROWTH IS X REGULATED

A

Oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Risk factors for breast cancer? (7)

A

lifetime of exposure to oestrogens:

  • Early age of onset of menarche (start of periods)
  • age to first full-term pregnancy (early age is a protective factor)
  • Some contraceptive pills
  • Some hormone-replacement therapies
  • Obesity
  • Diet, physical activity, height, medication (Aspirin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Following menopause the breast undergoes X

A

atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does the oestrogen receptor lead to breast cancer (what is the name of the gene sequence it activates)

A
  • Activated upon binding oestrogen
  • Oestrogen being a steroid hormone is able to cross the cell membrane very easily
  • Gene Expression is Induced by Binding to Specific DNA Sequences called Oestrogen Response Elements
  • The Oestrogen-Induced Gene Products Increase Cell Proliferation, Resulting in Breast Cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the oestrogen receptor usually bound to

A

HSP90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Oestrogen binding allows the receptor to detach from X and Y

A

HSP90

dimerise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

We call the proteins that are able to bind to ligands and activate transcription ….

A

Nuclear activators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Nuclear activators are…

A

the proteins that are able to bind to ligands and activate transcription

31
Q

Which gene products are heavily oestrogen regulated (4)

A

Progesterone receptor
Cyclin D1
C-Myc
TGF-alpha

32
Q
  • 1/3 of premenopausal women with advanced breast cancer will respond to ….
A

oophorectomy (surgical removal of both ovaries

33
Q

What is used to treat premenopausal women normal breast cancer

A

Oophorectomy

34
Q

How do we treat normal breast cancer in postmenopausal some and why does this work

A

With high-dose therapy of synthetic oestrogens, this regress because of overstimulation of the oestrogen receptor leading to the cell degrading that receptor

35
Q

Peak af problem synthetic oestrogen therapy can cause if not careful, and less peak problems?

A

Metastatic disease and bare side effects

36
Q

Difference in prognosis between men and women in ER overexpression

A

Better for women worse for men

37
Q

How to treat BC with overexpressed oestrogen receptors?

A
  • Oestrogen withdrawal or competition for binding to the ER using anti-estrogens results in a response in about 70% of ER-positive cancers (5-10% of ER-negative also respond)
38
Q

Primary therapy for BC

A

Surgery

39
Q

Types of surgery for BC? (3)

A

Oophorectomy, complete mastectomy or smaller lumpectomies

40
Q

What is removed post tumour removal in BC and why?

A

remove sentinel lymph nodes to check for indications of metastasis

41
Q

Main treatments for BC?

A
  1. Surgery
  2. Radiation therapy
  3. Chemotherapy
  4. Endocrine therapy
42
Q

When does endocrine therapy take place

A

Usually post surgery as an adjuvant, can be pre too as a neoadjuvant to shrink tumour

43
Q

Why is endocrine therapy used adjuvantly

A
  • In accessing the tumour, you liberate tumour cells, so in order to stop these from forming new tumours, we use endocrine therapy
44
Q

Aim of endocrine therapy?

A

INHIBITING OESTROGEN ACTION IN BREAST CANCE

45
Q

Three levels of endocrine therapy?

A
  • Ovarian suppression – STOP OVARIES MAKING OESTROGEN
  • Blocking oestrogen production by enzymatic inhibition
  • Inhibiting oestrogen responses
46
Q

Where produces oestrogens

A

Peripheral conversion of androgens to oestrogens

And ovary obvs

47
Q

2 ways of carrying out physical ovarian ablation?

A
  • Surgical oophorectomy

- Ovarian Irradiation

48
Q

Problems with ovarian ablation

A

morbidity and irreversibility

49
Q

Reversible and reliable medical ovarian ablation can be achieved using Luteinising Hormone Releasing Hormone (LHRH) agonists
in Y women

A

premenopausal

50
Q

Goserelin, Buserelin, Leuprolide, Triptorelin are examples of

A

LHRH agonists

51
Q

How do LHRH agonists work

A
  • LHRH agonists bind to LHRH receptors in the pituitary leading to receptor down-regulation and suppression of LH release and inhibition of ovarian function, including oestrogen production
52
Q

3 pharmacological ways to decrease oestrogen in women

A

LHRH agonists
Aromatase inhibitors
Antiestrogens

53
Q

examples of SERM

A
  • Tamoxifen looks like oestrogen to the ER
54
Q

What is tamoxifen

A
  • Tamoxifen is a selective estrogen receptor modulators (SERMs)
    Its a competitive inhibitor of oestradiol binding to the ER
55
Q

What does an antiestrogen like tamoxifen cause

A
  • Anti-oestrogens negate the stimulatory effects of oestrogen by blocking the ER, causing the cell to be held at the G1 phase of the cell cycle
56
Q

Why is tamoxifen particularly good

A

NOTE: Tamoxifen has oestrogenic effects on bone (rather than anti-oestrogenic), so it does not cause osteoporosis as someone might hypothesise
NOTE2: Similarly, in atherosclerosis, oestrogen is protective due to influences on cholesterol levels, and tamoxifen has oestrogenic CVS effects (so it doesn’t cause CVS problems like one might hypothesise)

57
Q

Side effects of tamoxifen in treatment

A
  1. Tamoxifen for advanced breast cancer has been associated with subsequent thromboembolic episodes
  2. Tamoxifen is known to produce endometrial thickening, hyperplasia, and fibroids following several years of therapy
58
Q

What are the 2 uses of tamoxifen

A

Breast cancer prevention and therapy

59
Q

Side effects of tamoxifen in prevention

A
  • Increase incidence of endometrial cancer
  • Stroke
  • Deep Vein Thrombosis
  • Cataracts
60
Q

In postmenopausal women, the major source of oestrogen come from …

A

conversion of the adrenal hormones Androstenedione (A) and (to a lesser extent) Testosterone, to Oestrone (E2)

61
Q

The peripheral conversion of androstenedione and testosterone is catalysed by ..

A

aromatase enzyme complex

62
Q

The peripheral conversion of androstenedione and testosterone happens in …

A

sites such as fat, liver, and muscle

63
Q

What molecules are converted into oestrogen by aromatase

A

Androstenedione

Testosterone

64
Q

What does aromatase consist of

A

NADPH, cytochrome P450 reductase and cytochrome P450

65
Q

What number and type of reaction converts Androstenedione to oestrogen

A

3 hydroxylations

66
Q

What else can aromatase do to Androstenedione bar convert to oestrogen

A

metabolise to Oestrone Sulphate

67
Q

Difference between the 2 types of aromatase inhibitors?

A

T1 irreversible

T2 reversible

68
Q

Progestin response in the human breast causes …

A

Proliferation and differentiation

69
Q

How does progestin help with breast cancer

A

Overstimulation of the progesterone receptor leads to downregulating receptor

70
Q

2 treatment methods targeting ER in BC?

A

 Anti-oestrogens e.g. tamoxifen

 Inhibitors of estrogen synthesis e.g. exomestane

71
Q

Clinical problem with targeting ER in BC?

A
  • Initial response but eventual relapse
  • Relapse due to resistance during prolonged endocrine therapy
  • NOT due to tumours becoming ER-independent
  • Recent data shows that resistant tumours have mutated ER
72
Q

Solution to the problem of relapse with ER treatment?

A
  • Continue use endocrine therapies as these are successful

- But, require additional therapeutic agents/ strategies for endocrine resistant, metastatic disease

73
Q

Age for BC screening?

A

all women between 50 and 64y/o who are registered to a UK GP (this is being extended to 70y/o)
- Patients asked to attend once every 3 years

74
Q

Recommended treatment for ER -ve tumours?

A

Chemo

Cancer Y2 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions