Carcinoma of the breast Flashcards
1
Q
What is the triple approach to breast lumps?
A
- Clinical examination
- Radiology
- Fine needle biopsy
2
Q
What are the common causes of a discrete breast lump?
A
- Fibroadenoma
- Cyst
- Very localised fibroadenosis
3
Q
What factors affect risk of breast cancer development?
A
- Age (>50)
- Country of birth (lower risk in asia/africa)
- First degree relative affected
- Nulliparity
- Previous breast cancer
- History of atypical hyperplasia
4
Q
What does pleomorphic micro calcification suggest?
A
DCIS
5
Q
What mammography findings are suspicious for malignancy?
A
- Poorly defined mass w/ spiculated border
- Microcalcifications
- Architectural distortion
- Interval mammographic changes
6
Q
When should genetic screening be considered?
A
- Pt w/ breast + ovarian ca
- Strong FHx
- FHx male breast cancer
- Young pt (
7
Q
What is the clinical staging of breast cancer?
A
- Tumour size by palpation/mammogram
- Nodal involvement by palpation
- Metastasis by exam, CT CAP
8
Q
What is the pathological staging of breast cancer?
A
- Tumour size
- Grade: modified Bloom and Richardson (I-III) - histologic, nuclear and mitotic grade
- Number of nodes +/ve out of total resected
- ER and PR testing
- Her2Neu receptor testing
- Margins: -ve,
9
Q
What is DCIS?
A
Proliferation of malignant ductal epithelial cells completely contained within breast ducts, often multifocal; risk of invasive carcinoma 35% at 10y.
10
Q
Mx DCIS?
A
- Lumpectomy w/ wide excision margins + radiation
- Mastectomy (if large area/high grade/multifocal).
- +/- adjuvant therapy
11
Q
5y survival of treated DCIS?
A
99%
