Introduction to Cancer Medicine Flashcards
What are the hallmarks of cancer?
Transformation from a cell of origin
Acquisition of invasive properties
Activation of cellular proliferative signals
Abrogation of cell cycle control
Up-regulation of angiogenesis
Further clonal evolution
A 52 year old woman notices a possible lump in her left breast but is otherwise very well. What does the doctor need to do?
Full history and examination
Assess breast mass
Imaging
Referral to breast surgeon
What should be included in a full history of a patient presenting with a lump in their breast?
Family history of cancer
History of the lump, including temporal history, size pain
What should be included in an assessment of a lump in the breast?
Hard vs soft?
Regular vs irregular
Skin changes
Nipple retraction
What imaging modalities should be used in the assessment of a breast lump?
Ultrasound
Mammography
What questions are being asked when imaging a breast lump?
Is it a cyst, fibroadenoma or cancer?
What will a breast surgeon do to a lump in the breast that has not yet been confirmed as breast cancer?
Large needle biopsy
What 3 investigations are required to accurately assess a breast lump?
Examination
Imaging
Biopsy
What molecular pathology should be investigated from a biopsy of a breast lump?
Oestrogen receptor positivity
Progesterone receptor positivity
Her-2 positivity
Gene arrays
What are the 3 different stagings of breast cancer?
Tumour
Nodes
Metastases
What is adjuvant therapy?
Treatment that is given in addition to the primary, main or initial treatment.
What is an example of adjuvant therapy to breast cancer?
Radiotherapy
What is the advantage of adjuvant therapy?
Reduces the risk of local and systemic recurrence, improving overall survival
What are the disadvantages of adjuvant therapy?
Finite therapy
Large numbers of patients treated for some individuals to benefit
Tolerate some toxicity
What are some local treatments for breast cancer?
Surgery
Radiotherapy
