Diagnosis and Classification of Breast Cancer

Question 1

incidence of breast cancer

Answer 1

1 in 8

Question 2

cell origin of breast carcinoma

Answer 2

epithelium of ducts (ductal) or lobules (lobular)

Question 3

true/false - breast cancer is the commonest cause of death in women

Answer 3

false - commonest cancer cause of death

Question 4

true/false - the incidence of breast cancer is rising

Answer 4

true

Question 5

give the 3 modifiable risk factors for breast cancer

Answer 5

obesity, alcohol, HRT/COC and not breastfeeding

Question 6

give 3 genes associated with breast cancer

Answer 6

BRCA1 and 2, p53 and HER2

Question 7

what other cancer is associated with BRCA1 and 2

Answer 7

ovarian cancer

Question 8

what is HER2

Answer 8

an oncogene which increases cell division by tyrosine kinase

Question 9

what BRCA carries a higher risk of breast cancer

Answer 9

BRCA1

Question 10

give 5 non-modifiable risk factors

Answer 10

older
early menarche or late menopause
1st degree relative with pre-menopausal breast Ca
BRCA1/2
p53

Question 11

how does nulliparity increase breast Ca risk

Answer 11

more exposure to oestrogen

Question 12

what cancer treatment predisposes to breast Ca

Answer 12

radiotherapy for Hodgkin’s lymphoma

Question 13

two types of non-invasive

Answer 13

ductal and lobular

Question 14

what is the most common kind of invasive breast cancer

Answer 14

invasive ductal carcinoma

Question 15

how is the type of tumour identified

Answer 15

core biopsy for histology

Question 16

what is meant by in-situ

Answer 16

non-invasive, just sitting in the wall without damaging it or spreading

Question 17

5 molecular classifications of breast Ca

Answer 17

luminal A
luminal B
basal/triple negative
HER-2 positive
normal breast-like

Question 18

what factors determine the molecular classification of the tumour

Answer 18

whether they have eostrogen or progesterone receptors and whether they’re HER2 positive

Question 19

what % are luminal A

Answer 19

55%

Question 20

what % are luminal B

Answer 20

15%

Question 21

what % are HER2 positive

Answer 21

15-20%

Question 22

if the tumour is HER2 -ve what is the most likely molecular class

Answer 22

luminal A

Question 23

4 types of imaging for breast Ca

Answer 23

mammogram
US
MRI
nuclear

Question 24

what does a breast Ca look like on mammogram

Answer 24

calcification, mass, asymmetry and architectural distortion

Question 25

elements of triple assessment

Answer 25

examination
imaging
FNA and cytology

Question 26

what does a cytology determine

Answer 26

the likelihood of malignancy and maybe the type (lobular or ductal)

Question 27

if 1 of the triple assessment is +ve what is the next investigation

Answer 27

core biopsy

Question 28

what tells you the aggressiveness

Answer 28

grade - 1, 2 or 3

Question 29

5 sites of metastases from breast

Answer 29

skin, bone, liver, lungs and brain

Question 30

basics of breast screening programme

Answer 30

50-70 y/o every 3 years for a mammogram to detect in DCIS stage

Question 31

how effective is breast screening

Answer 31

reduces mortality by 30%

Question 32

overall 5 year survivial

Answer 32

64%

Question 33

what scoring system is used to assess prognosis

Answer 33

nottingham prognostic index