malignant breast disease

Question 1

when might nipple discharge indicate malignancy

Answer 1

if it’s blood stained!!

Question 2

where is the male breast found

Answer 2

just under the nipple areolar complex

Question 3

peak incidence for male breast cancer

Answer 3

75yrs

Question 4

name some environmental risk factors for male breast cancer

Answer 4

radiotherapy, hot work environments (furnaces, steel workers)

Question 5

name some hormonal risk factors for male breast cancer

Answer 5

exogenous: prostate cancer, transgender
endogenous: XXY, testicular problems

Question 6

management of male breast cancer

Answer 6

mastectomy + adjuvant radiotherapy

Question 7

what is paget’s disease of the nipple

Answer 7

cancer cells in the skin of the nipple

Question 8

how does paget’s disease of the nipple usually present

Answer 8

eczema-like rash of the nipple
itchy, red, crusty, inflamed

Question 9

investigation for pagets disease of the nipple

Answer 9

incisional or punch biopsy

Question 10

management of paget’s disease of the nipple

Answer 10

surgery

Question 11

what is breast carcinoma

Answer 11

a malignant tumour of breast epithelial cells

Question 12

name some lifestyle factors that increase the risk of breast carcinoma

Answer 12

obesity, low physical activity, alcohol, smoking

Question 13

name a drug that is a protective factor against breast carcinoma

Answer 13

NSAID

Question 14

name some risk factors for breast cancer

Answer 14

female sex, family history, early menarche, late menopause, nulliparous women, oral contraceptives and HRT use

Question 15

where does breast carcinoma arise

Answer 15

in the glandular epithelium of the terminal duct lobar unit

Question 16

what is the most common type of invasive carcinoma

Answer 16

invasive ductal carcinoma

Question 17

what are the 2 main types of invasive carcinoma

Answer 17

lobular and ductal

Question 18

why do we test to see if a patient expresses oestrogen receptors

Answer 18

to predict their response to anti-oestrogen therapy

Question 19

anti-oestrogen therapy used in breast carcinoma

Answer 19

tamoxifen

Question 20

where does breast carcinoma commonly metastasise to

Answer 20

bone, liver, brain, lungs

Question 21

investigation for breast carcinoma

Answer 21

triple assessment

Question 22

what is the triple assessment in breast carcinoma

Answer 22

clinical assessment - history and exam
imaging - mammography and USS
histology

Question 23

chemo for her2 positive patients

Answer 23

herceptin

Question 24

chemo for her2 negative, hormone receptor positive patients

Answer 24

abermaciclib

Question 25

chemo for triple negative breast cancer

Answer 25

pembrolizumab

Question 26

chemo for BRCA positive, her2 negative high risk early breast cancer

Answer 26

olaparib (PSTP inhibitor)

Question 27

what hormone therapy is typically used in premenopausal women

Answer 27

tamoxifen

Question 28

what is lobular carcinoma in situ

Answer 28

malignancy of the secretory lobules of the breast that is contained within the basement membrane

Question 29

relationship between lobular carcinoma in situ and menopause

Answer 29

incidence decreases after menopause

Question 30

what is triple negative breast cancer

Answer 30

lacks oestrogen and progesterone receptors and doesn't have an excess of her 2 protein on the cell surfaces -> AGRESSIVE

Question 31

what is HER2

Answer 31

human epidermal growth factor receptor which promotes the growth of cancer cells

Question 32

clinical presentation of lobar carcinoma in situ

Answer 32

usually asymptomatic and picked up during screening

Question 33

management of lobal CIS discovered on core biopsy

Answer 33

excision or vacuum biopsy

Question 34

what is the most common type of non-invasive breast malignancy

Answer 34

ductal carcinoma in situ

Question 35

what is ductal carcinoma in situ

Answer 35

malignancy of the ductal tissue of the breast that is contained within the basement membrane

Question 36

ductal carcinoma in situ on mammography

Answer 36

microcalcifications

Question 37

management of ductal carcinoma in situ

Answer 37

complete wide excision