carcinoma of the breast Flashcards
Tell me about breast carcinoma
malignancy of the breast tissue
can be ductal (from milk ducts)
or
Lobular (from lobules)
can be in situ or invasive
What is Paget’s disease of the breast
infiltrating carcinoma of the nipple epithelium
1% of all breast cancers
Who is affected by breast carcinoma
mainly women, but can affect men
Risk factors of breast carcinoma
Female
increasing age
smoking
Fx
Genetics - BRCA1, BRCA2 and TP53 mutatuions
No children
never breastfed
early menarche and late menopause
Continuous combined HRT
Raditation
Alcohol
Gynaecomastia
What is menarche
Beginning of menstruation
Clinical presentation of breast carcinoma
Lump (80%), painful in 20%
Nipple change 10%
Nipple discharge 3%
skin contour changes
breast pain/mastalgia alone uncommon
bloody nipple discharge - intraductal carcinoma
Describe the lump of breast carcinoma
hard irregular fixed painless dimpling tethering peau d'orange
What is mastalgia
Breast pain
Differntial diagnosis of breast carcinoma
Fibrocystic breast disease
Intraductal papilloma
Cyst
How to investigate breast carcinoma
Mammography
Fine needle aspiration
Core biopsy
How is breast carcinoma staged
TNM
Management of breast carcinoma
wide local excision or mastectiomy with radiotherapy followed by breast reconstruciton
Hormonal therapy if tumour positive to tumour receptors
Herceptin used for those expressing HER2 gene
Chemotherapy for patients with endocrine unresponsive tumours