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Medicine Unit 2 > PBL Week 1 Wrap up > Flashcards

PBL Week 1 Wrap up Flashcards

1
Q

what is fibroadenoma

A

tumour made up of fibrous tissue, tumour of gland tissue
may be related to reproductive hormones
occur more often in reproductive years, bigger during pregnancy or with use of hormone therapy, may shrink after menopause

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2
Q

what are the types of fibroadenoma

A

juvenile
giant
complex
phyllodes

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3
Q

juvenile fibroadenomas

A

most common type found in girls and adolescents between ages 10 and 18
can grow large, most shrink over time, some disappear

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4
Q

giant fibroadenomas

A

can grow larger than 2 inches
may need to be removed as can press on breast tissue

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5
Q

complex fibroadenomas

A

contain overgrowth of cells (hyperplasia) due to changes in cell proliferation
pathologist makes diagnosis after reviewing the tissue from a biopsy

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6
Q

phyllodes tumour

A

usually benign
some can become malignant
normally recommend removal

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7
Q

most common type of cancer in females

A

breast cancer

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8
Q

when do you get invited for mammograms and how frequently

A

women age 50-53
every three years

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9
Q

what is the mortality rate that breast cancer accounts for out of all cancer deaths in females

A

15%

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10
Q

how many breast cancer cases are presented in GP clinics

A

80%

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11
Q

what are the three stages of triple assessment

A

clinical examination
mammography and/or ultrasound imaging
core biopsy and/or fine needle aspiration cytology

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12
Q

whoo do fibroadenomas usually our in

A

younger menopausal women

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13
Q

what occurs in stage one breast cancer

A

less than 2cm
hasn’t spread

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14
Q

what occurs in stage 2 breast caner

A

less than 2cm
lymph nodes metastasis
greater than or equal to 2cm

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15
Q

stage 3 breast cancer

A

any size but has spread to axillary lymph nodes

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16
Q

stage 4 breast cancer

A

spread to other organs of the body such as lungs, skin, liver, bones or brain

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17
Q

what percentage of breast cancer patients survive more than 10 years

A

75% but dependent on the stage

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18
Q

what is the percentage rate of survival of 5 years in stage 4 metastatic breast cancer

A

20%

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19
Q

what are the 4 types of breast cancer

A

HR-/HER2- (triple negative)
HR-/HER2+ (least common)
HR+/HER2+ (triple positive)
HR+/HER2- (most common)

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20
Q

what do all breast cancer cases firstly subdivide into

A

HR- or HR+
HR- is ER- and PR-
HR+ is ER+ or PR+

HR means hormone
ER means oestrogen
PR means progesterone
+ is high level
- is normal level

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21
Q

triple negative breast cancer

A

13% of all cases
most difficult to treat
HR-/HER2-

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22
Q

least common type of breast cancer

A

HR-/HER2+
5% of all cases

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23
Q

triple positive breast cancer

A

HR+/HER2+
10% of all cases

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24
Q

most common type of breast cancer

A

HE+/HER2-
73% of all cases

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25
Q

most difficult breast cancer to treat

A

triple negative
70% of these patients have BRCA mutations

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26
Q

what is the most common hereditary gene mutation in breast cancer

A

mutation in the BRCA gene
BRCA 1 and BRCA 2 account for 60% of mutation caused cancer

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27
Q

what percentage of the female population have a higher predisposition to breast cancer

A

10-15%

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28
Q

hormonal risk factors for breast cancer

A

early menarche
late menopause
greater age of first full-term pregnancy
oral contraceptives
hormone replacement therapy

29
Q

non-hormonal risk factors for breast cancer

A

alcohol
obesity
age

30
Q

risk factors for breast cancer associated with a high socioeconomic background

A

greater age at first full-term pregnancy
oral contraceptives
hormone replacement therapy

31
Q

breast cancer in more deprived areas

A

14% fewer cases
may be due to a lower uptake of breast cancer screening

32
Q

what is a benign tumour

A

doesn’t invade and destroy the tissue in which it originates or spread to distant sites in the body
non-cancerous

33
Q

what is a malignant tumour

A

invades and destroys tissue in which it originates and has the potential to spread to other sites in the body via the bloodstream and lymphatic system

34
Q

presentation of a fibroadenoma

A

painless usually small hard lump in the breast

35
Q

two categories for breast cancer

A

invasive
non-invasive

36
Q

non-invasive breast cancers

A

DCIS (ductal cancer in situ)- cancer cells developed in the ducts but haven’t spread beyond
LCIS (lobular cancer in situ)- abnormal cells have developed in the lobules

37
Q

invasive breast cancers

A

invasive breast cancer- cancer cells grown through the duct lining into the surrounding breast tissue (medullary, papillary, tubular, mucinous)
invasive lobular breast cancer- cancer cells started to grow in the lobules and have spread to the surrounding tissues
inflammatory breast cancer- within the lymph vessels in the skin of the breast, inflamed and painful
pagets disease- develops in the nipple or areola
angiosarcoma- start in blood or lymphatic vessels within the breast ,primary and secondar y

38
Q

what genes are associated with developing breast cancer

A

BRCA1
BRCA2
HER2
proto-oncogene
membrane tyrosine kinase
TP53
CHEK2

39
Q

BRCA1

A

tumour suppressor involved in double strand breaks of DNA and transcription coupled repair
women with mutation have 55-65% risk breast cancer and 40% ovarian

40
Q

BRCA2

A

involved in double strand break repair and have 40% increased risk of breast cancer

41
Q

HER2

A

human epidermal growth factor receptor 2
HER2 gene amplification leads to HER2 protein over expression

42
Q

TP53

A

tumour suppressor gene
if p53 is faulty it fails to stop cell division
TP53 can be inherited or spontaneous , also binds to apoptosis regulator PTEN

43
Q

CHEK2

A

encodes for checkpoint tyrosine kinase which acts as a tumour suppressor

44
Q

types of DNA mutations

A

point mutation
addition
deletion
inversion
duplication

45
Q

what are the potential breast cancer treatments

A

surgery- first treatment
chemotherapy
radiotherapy
hormone therapy
targeted therapy

46
Q

breast cancer surgery

A

breast-conserving: only remove the tumour
mastectomy- remove whole breast and the nipple

47
Q

chemotherapy

A

using anticancer (cytotoxic) medicine to destroy cancer cells
can stop oestrogen production, can encourage breast cancer growth
Neo-adjuvant: chemo done before surgery, often used to shrink a large tumour
side effects: loss of appetite, feeling sick, tiredness, hair loss, sore mouth, infections

48
Q

radiotherapy

A

doses of radiation to destroy cancer cells
last 3-5 weeks
side effects: extreme tiredness, irritation and darkening of skin on the breast

49
Q

hormone therapy

A

lowers level of oestrogen and progesterone in the body, stimulate breast cancer growth or stop effects
breast cancer cells
breast cancer ells have receptors where oestrogen and progesterone attach to help them grow
tamoxifen is most common hormone therapy, can be used in pre and post menopausal women, blocks oestrogen receptors on cancer cells in breast

50
Q

targeted therapies

A

change the way cells work and help to stop cancer from growing and spreading
can be given via a drip in the vein, pill or as an injection under the skin
side effects: shivering, diarrhoea, sickness, headache, cough, skin rash

51
Q

treatment for fibroadenoma

A

only treated if fast growing, large or causing symptoms
1. surgical excision: cutting out using knife
2. freezing it: thin wand shaped device is inserted, freezes lump, ultrasound used to guide wand to Lump

52
Q

why are breast cancer assessments less accurate in younger patients

A

as patients get older the breast shrinks
density reduces
abnormalities are easier to differentiate from normal breast tissue

53
Q

what occurs in a clinical assessment

A

take the history:
-symptoms
-risk factors
examination:
-observe breast and axilla for symmetry, colour and masses
-feel each quadrant of breast and axillary tail
-is the mass fixed or mobile

54
Q

symptoms of breast cancer q

A

breast lump
skin
nipple change
discharge
pain
duration
patterns

55
Q

types of imaging used in breast cancer

A

mammography
breast ultrasound
MRI
staging axillary ultrasound

56
Q

mammography

A

low dose X-rays
used in ages 40+ due to glandular tissue density
look for lesions, asymmetry, skin thickening, lymph nodes

57
Q

breast ultrasound

A

sound waves
measures size of cancer
can guide needle biopsies
more curate than mammography in younger patients

58
Q

MRI

A

detects subtle morphological changes but poorly differentiates between benign and malignant lesions

59
Q

staging axillary ultrasound

A

looks for enlarged lymph nodes with increased thickness

60
Q

methods for pathology for breast cancer

A

biopsy
fine needle aspiration cytology
vacuum assisted biopsy/ mammotome

61
Q

biopsy

A

3-5,1.6mm diameter cylinders of tissue removed and tested

62
Q

fine needle aspiration cytology FNAC

A

reserved for very small/superficial lesions that would be difficult to biopsy otherwise

63
Q

vacuum assisted biopsy VAB/ mammotome

A

larger biopsy
probe used to collect tissue samples through small 1/4 inch incisions

64
Q

non-urgent GP referral

A

longer than 2 weeks

65
Q

urgent GP referral

A

within 2 weeks

66
Q

very urgent GP referrals

A

within 48 hours

67
Q

what is a multidisciplinary team

A

team of healthcare professionals who meet to discuss a patient

68
Q

support available for breast cancer patients

A

national hereditary breast cancer helpline
screening programmes
public health “be clear on cancer”

69
Q

coping with bereavement of breast cancer

A

live chat forum
mental health guides
talk to family and friends
living healthy lifestyle

Medicine Unit 2 (28 decks)

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