L3: Breast Cancer - Pt 6

Question 1

Managemnt of Breast Cancer With Pregnancy

• Stage I & II

Answer 1

Question 2

Management of Breast Cancer With Pregnancy in Stage I & II

• 1st Trimester

Answer 2

Question 3

Management of Breast Cancer With Pregnancy in Stage I & II

• 1st Trimester (precious Baby)

Answer 3

Question 4

Management of Breast Cancer With Pregnancy in Stage I & II

• 1st Trimester (Not Precious Baby)

Answer 4

Question 5

Management of Breast Cancer With Pregnancy in Stage I & II

• 2nd Trimester

Answer 5

Early: as 1st trimester
Late: as 3rd trimester

Question 6

Management of Breast Cancer With Pregnancy in Stage I & II

• 3rd Trimester

Answer 6

Question 7

Management of Breast Cancer With Pregnancy in Stage I & II

• 3rd Trimester (Before Labor)

Answer 7

• Surgery
• Chemotherapy can be given safely
• Radiotherapy after labor.

Question 8

Management of Breast Cancer With Pregnancy in Stage I & II

• 3rd Trimester (After Labor)

Answer 8

• Early induction of labor at 32 weeks, then manage as usual

Question 9

Management of Breast Cancer With Pregnancy in Stage III

• 1st Trimester

Answer 9

• Neoadjuvant chemotherapy, but patient should be counselled about the risks to the faetus

Question 10

Management of Breast Cancer With Pregnancy in Stage III

• 2nd & 3rd Trimester

Answer 10

▪ Chemotherapy, then surgery, then radiotherapy after delivery

▪ If ER/PR +ve: tamoxifen is given

Question 11

Management of Breast Cancer With Pregnancy in Stage III

• Immediate reconstruction with flaps is …….

Answer 11

• Contraindicated during pregnancy due to

1. prolonged anesthesia
2. Blood loss
3. Inability to obtain symmetry

Question 12

Management of Breast Cancer With Pregnancy in Stage III

• Axillary staging?

Answer 12

No SLNB

• as radiocolloids and blue dyes are not safe during pregnancy or lactation (SLNB proved safety in recent studies, Tc99 was the tracer used)

Question 13

Management of Breast Cancer With Pregnancy in Stage III

• Stage IV

Answer 13

Pregnancy termination and treat as usual

Question 14

Predisposing Factors for Male Breast Cancer

Answer 14

as before +

▪ Klinefelter syndrome (47 XXY karyotype, gynaecomastia, and small firm testes)

▪ Prolactinoma.

Gynecomastia is no longer believed to increase the risk

Question 15

Pathological Types in Male Breast Cancer

Answer 15

▪ 90% of MBC are invasive, of these 80% are IDC and 5% are papillary.

▪ 10% of MBC are CIS, DCIS mainly papillary and cribriform types.
——-

▪ Invasive lobular carcinoma represents 1% of MBC.

▪ LCIS is rare.
——–
▪ 80% of MBC are ER +ve while 75% of MBC are PR + ve (more than females)

Question 16

Prognosis of Male Breast Cancer

Answer 16