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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
most difficult breast cancer to treat
triple negative 70% of these patients have BRCA mutations
26
what is the most common hereditary gene mutation in breast cancer
mutation in the BRCA gene BRCA 1 and BRCA 2 account for 60% of mutation caused cancer
27
what percentage of the female population have a higher predisposition to breast cancer
10-15%
28
hormonal risk factors for breast cancer
early menarche late menopause greater age of first full-term pregnancy oral contraceptives hormone replacement therapy
29
non-hormonal risk factors for breast cancer
alcohol obesity age
30
risk factors for breast cancer associated with a high socioeconomic background
greater age at first full-term pregnancy oral contraceptives hormone replacement therapy
31
breast cancer in more deprived areas
14% fewer cases may be due to a lower uptake of breast cancer screening
32
what is a benign tumour
doesn't invade and destroy the tissue in which it originates or spread to distant sites in the body non-cancerous
33
what is a malignant tumour
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
presentation of a fibroadenoma
painless usually small hard lump in the breast
35
two categories for breast cancer
invasive non-invasive
36
non-invasive breast cancers
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
invasive breast cancers
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
what genes are associated with developing breast cancer
BRCA1 BRCA2 HER2 proto-oncogene membrane tyrosine kinase TP53 CHEK2
39
BRCA1
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
BRCA2
involved in double strand break repair and have 40% increased risk of breast cancer
41
HER2
human epidermal growth factor receptor 2 HER2 gene amplification leads to HER2 protein over expression
42
TP53
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
CHEK2
encodes for checkpoint tyrosine kinase which acts as a tumour suppressor
44
types of DNA mutations
point mutation addition deletion inversion duplication
45
what are the potential breast cancer treatments
surgery- first treatment chemotherapy radiotherapy hormone therapy targeted therapy
46
breast cancer surgery
breast-conserving: only remove the tumour mastectomy- remove whole breast and the nipple
47
chemotherapy
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
radiotherapy
doses of radiation to destroy cancer cells last 3-5 weeks side effects: extreme tiredness, irritation and darkening of skin on the breast
49
hormone therapy
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
targeted therapies
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
treatment for fibroadenoma
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
why are breast cancer assessments less accurate in younger patients
as patients get older the breast shrinks density reduces abnormalities are easier to differentiate from normal breast tissue
53
what occurs in a clinical assessment
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
symptoms of breast cancer q
breast lump skin nipple change discharge pain duration patterns
55
types of imaging used in breast cancer
mammography breast ultrasound MRI staging axillary ultrasound
56
mammography
low dose X-rays used in ages 40+ due to glandular tissue density look for lesions, asymmetry, skin thickening, lymph nodes
57
breast ultrasound
sound waves measures size of cancer can guide needle biopsies more curate than mammography in younger patients
58
MRI
detects subtle morphological changes but poorly differentiates between benign and malignant lesions
59
staging axillary ultrasound
looks for enlarged lymph nodes with increased thickness
60
methods for pathology for breast cancer
biopsy fine needle aspiration cytology vacuum assisted biopsy/ mammotome
61
biopsy
3-5,1.6mm diameter cylinders of tissue removed and tested
62
fine needle aspiration cytology FNAC
reserved for very small/superficial lesions that would be difficult to biopsy otherwise
63
vacuum assisted biopsy VAB/ mammotome
larger biopsy probe used to collect tissue samples through small 1/4 inch incisions
64
non-urgent GP referral
longer than 2 weeks
65
urgent GP referral
within 2 weeks
66
very urgent GP referrals
within 48 hours
67
what is a multidisciplinary team
team of healthcare professionals who meet to discuss a patient
68
support available for breast cancer patients
national hereditary breast cancer helpline screening programmes public health "be clear on cancer"
69
coping with bereavement of breast cancer
live chat forum mental health guides talk to family and friends living healthy lifestyle

Medicine Unit 2 (28 decks)

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