Clinical Breast Cancer

Question 0

Prevention

Answer 0

Only recommended for women at high risk of developing breast cancer

Can be prevented by medical (Tamoxifen, Raloxifene) or surgical approaches (mastectomy, oophorectomy)

Question 1

Gail model

Answer 1

Used for overall risk assessment incorporating number of first-degree relatives, age at first live birth, number of breast biopsies, and the presence of atypical hyperplasia on biopsy

Question 2

Four main molecular classes

Answer 2

Luminal A: ER positive, PR positive and HER2 negative, hormone receptor positive breast CA
Luminal B: ER positive, PR positive and HER2 positive, hormone receptor positive breast CA
HER2: ER negative, PR negative and HER2 positive, hormone receptor negative breast CA
Basal: ER negative, PR negative and HER2 negative, hormone receptor negative breast CA

Question 3

Gene expression profiling

Answer 3

Measures the abundance of mRNA in cells or tissues and gives a global picture of gene expression

Question 4

Gene profiling: Oncotype DX and Mammaprint

Answer 4

Oncotype DX: reverse transcriptase PCR assay based on the analysis of the expression of 21 genes to provide a recurrence score, very specific assay, only for patients who are lymph node negative and estrogen receptor positive, can help reduce the chemo treatments for patients who don’t need it, cost-effective

Mammaprint: DNA microarray assay based on the analysis of 70 genes to identify patients with good or bad signatures