L19-Breast cancer: causes to cures Flashcards
What is the effect of obesity on cancer?
Obesity activates the IGF and insulin pathways aswell as PI3K. It also causes increased oestrogen production that all enhance risk of breast cancer.
What are the differences between BRCA1 and BRCA2 mutations?
BRCA1 tends to be basal type breast cancer whereas BRCA2 tends to be high penetrance oestrogen receptor positive breast cancer.
What is the general anatomy of the breast and where can cancers arise?
The breast consists of lobules and then ducts that lead to the nipple. Can get cancer in the lobules or the ducts.
What are the three most common forms of breast cancer?
Ductal-NST (no special type), lobular and tubular
Which type of breast cancer is more likely to be multifocal (multiple cancers in different area of breast)?
The lobular cancer is more likely to have cancers in different lobules.
What do DCIS and LCIS stand for?
Ductal cancer in situ and lobular cancer in situ.
What is the most likely of breast cancers to metastisise and what does this cause to happen to the tissue?
Ductal is most likely to metastasis and this causes disruption of the basement membranes as the cells leave the tumour.
What is the HER2 receptor?
It is a human epidermal growth factor receptor that is encoded by an oncogene and often expressed in breast cancer.
How is breast cancer typically diagnosed?
Through triple assesment of clinical, radiological and pathological assesment.
What does the clinical part of breast cancer diagnosis involve?
Taking a good history
Inspection and palpation of the breast
Checking lymph nodes in the neck and axilla
What does the radiological part of breast cancer diagnosis include?
A mammogram which is most useful for picking up DCIS or can do ultrasound.
What deos the pathological part of breast cancer diagnosis involve?
A breast cancer core biopsy and FNA (fine needle aspiration)
What types of neo-adjuvant therapy are used for breast cancer?
Endocrine (aromatase inhibitors) - reduces oestrogen production by aromatase in adipose tissue
Chemotherapy
Herceptin (monoclonal antibody) - prevents HER2 activation by binding to it
What are the main types of surgery that are used?
Usually a wide local excision, masectomy or axillary lymph node removal. Usually followed by chemotherapy to mkae sure all cancer cells removed.
What are the main types of endocrine therapy that are used?
Tamoxifen - competitive oestrogen receptor inhibitor
Aromatase inhibitors - lowers oestrogen concentrations by stopping conversion in adipose tissue.
Ovarian suppression - GnRH agonists which suppress ovarian function.
