Clinical Approach to Breast Disease Flashcards
What are some risk factors for breast cancer?
- Female gender
- Family history of breast cancer
- Genetic predisposition
- Prior personal history of breast cancer
- Increased estrogen exposure
- Nulliparity or 1st pregnancy after age 30
- Lack of breastfeeding
What drugs can be used to reduce breast cancer risk?
SERMs - Tamoxifen and Raloxifene
Tamoxifen SE
- Risk of thromboembolism
- Increased risk of endometrial cancer
What age group of women benefit the most from breast cancer screening?
Women aged 60 to 69 years benefit the most
What is the minimum mammogram screening recommended?
At least biennial mammography between ages 55‐74 is agreed upon by most health agencies
What is the difference in cure rate of Modified Radical Mastectomy VS Breast Conserving Surgery?
Likelihood of cure is the same!
*** BCS requires radiation therapy though
What is the most important prognostic factor for breast cancer?
Lymph node involvement of the tumor
What is the use of tamoxifen in breast cancer?
- Standard agent used in pre and post‐menopausal women with ER/PR positive tumors
- Decreases risk of tumor recurrence by approximately 50%
Aromatase Inhibitor MOA
- Blocks aromatase enzyme in the final step of
estrogen biosynthesis - Blocks conversion of androgens (androstenedione and testosterone) to estrogens (estrone and estradiol)
What Adjuvant Chemotherapy is used with a HER2+ tumor?
Trastuzumab
What patients do aromatase inhibitors work in?
ONLY postmenopausal women
What patients does tamoxifen work in?
BOTH pre and postmenopausal women
What is the function of BRCA-1 and 2 and what is their inheritance?
Tumor suppressor genes - Autosomal dominant inheritance
What mutation is associated with male breast cancer?
BRCA-2
Inflammatory Breast Cancer
– Peau d’orange (orange peel appearance)
– Neoplastic cells block lymphatic drainage
