Introduction and Risk Factors for Breast Cancer Flashcards
At what age group is the largest incidence of breast cancer? Within this group, what is the biggest peak?
45-69, with the biggest peak being 65-69
How common is breast cancer?
The commonest cancer in women, and the 2nd commonest cause of cancer death in women
What is the relationship between incidence and prevalence of breast cancer and mortality at the moment?
Incidence and prevalence are increasing, mortality is decreasing
What are the two major generic risk factors for breast cancer?
Increasing age and female sex
In terms of genetics and family history, what conveys A) low risk? B) high risk?
A) first degree relative affected B) a relative with cancer at a young age/bilateral carcinomas
What are some reproductive risk factors for breast cancer?
Early menarche (< 12), late menopause, increased age at first birth (> 30), low/no parity, no breastfeeding
The presence of which hormone is a risk factor for breast cancer both endogenously and exogenously? What are some exogenous ways of becoming exposed to this?
Oestrogen - combined oral contraceptive pill, hormone replacement therapy
Which geographical locations have the highest risk of breast cancer?
Northern and Western Europe, USA
What are some lifestyle factors which increase the risk of breast cancer?
High body weight (post-menopausally) and significant weight gain in adult life, little physical activity, alcohol consumption, poor diet, smoking
What risk factors for breast cancer convey a relative risk of < 2?
Early menarche/late menopause, nulliparity, lifestyle factors, HRT, benign proliferative disease
What risk factors for breast cancer convey a relative risk of 2-4?
Aged > 35 at first birth, 1st degree relative with breast cancer, radiation exposure, previous breast cancer
What risk factors for breast cancer convey a relative risk of > 4?
Gene mutation, lobular/ductal carcinoma in situ, atypical hyperplasia of any kind
Which two modifiable lifestyle risk factors for breast cancer are associated with epidemiological decreased risk of breast cancer?
Routine vigourous activity and maintenance of healthy body weight
BRCA1 and BRCA2 mutations are each present in what percent of the population? Approximately 1 in how many people carry a mutation in one of these genes?
0.1%, 1 in 450
BRCA mutations are responsible for what % of breast cancers?
2%
If you have a BRCA1 or 2 mutation, what is your lifetime risk of developing breast cancer?
45-64%
What are the two main ways that breast cancer is detected? How common is each?
50% asymptomatic and detected via screening, 50% symptomatic and present with symptoms
Of all the women presenting with breast cancer, what symptom do 50% of them complain of?
Breast lump
What are the 6 main symptoms of breast cancer?
Visible/palpable lump, nipple change e.g. inversion, dimpled or depressed skin, bloody nipple discharge, skin texture change, skin colour change
What investigation is helpful in defining a malignant solid mass, particularly in younger women?
Ultrasound
What sign of breast cancer on imaging is often not picked up by ultrasound?
Calcifications
What investigation makes the definitive diagnosis of a breast cancer?
Image guided core-needle biopsy
