Malignant Conditions of the Breast

Question 1

What are the risk factors for breast cancer?

Answer 1

• Early menarche
• Later menopause
• Being older at first pregnancy/childbirth
• OC use
• HRT
• Obesity
• Tallness
• Denser breast tissue on mammography
• Alcohol
• Positive family history

Question 2

What are the two major divisions of breast cancer?

Answer 2

• Invasive ductal carcinoma (IDC)

- Invasive lobular carcinoma (ILC)

Question 3

What molecular classifications of breast cancer are there?

Answer 3

• Luminal A ER+ - low grade and less proliferative
• Luminal B ER+ - high grade and more proliferative
• Three types of ER- cancer; normal breast like, Her2, and basal-like

Question 4

What are the receptor based treatments of breast cancer?

Answer 4

• Oestrogen and progesterone receptor positive cancers respond to endocrine treatment (i.e. Tamoxifen or aromatase inhibitoon)
• Her2 positive cancers are treated with Trastuzumab (Herceptin)

Question 5

What histological properties is the Nottingham Prognostic Index based on?

Answer 5

• Nuclear pleomorphism
• The number of mitoses per mm2
• The degree of gland formation by the cancer cells

Question 6

What are the grades of the Nottingham Prognostic Index?

Answer 6

• Grade 1 (well differentiated and slow growing)
• Grade 2 (in between)
• Grade 3 ( poorly differentiated and fast growing)

Question 7

o Explain the Nottingham Prognostic Index?

Answer 7

• Grade + Stage + Tumour Size (cm) /5