Q's Flashcards
(28 cards)
What is the triple assessment for?
symptomatic patients
describe the breast screening programme
50-70 (every 3 years) - mammography
aims to detect DCIS (ductal carcinoma in situ)
What is MRI used for in breast imaging
- implant rupture
- Screening: 30-50 w/ high risk FHx (BRCA)
- lobular breast Ca
What is good for dense breast?
US (+ MRI)
Describe 2 breast biopsy techniques
Core biopsy
Fine needle asouration
Describe the triple assessment
- Examination (+ history)
- Imaging
- Pathology (e.g. biopsy)
What imaging is used in triple assessment of >40yo?
Mammogram + US
What imaging is used in the triple assessment of <40yo?
US
RFs for breast Ca
^ oestrogen: HRT, early monarche, no pregnancy, PCOS, obesity, COCP, later menopause
FHx/genetics
^ age
Male: kleinfelters + oestrogen therapy
protective factors for breast Ca
multiparous
most common type of breast cancer?
Adenocarcinoma (ductal)
Where does the second commonest breast cancer arise? What is good for imaging it?
lobular - mRI
give some tumour markers (receptors)
ER +ve
Her-2
Progesterone +ve
What tumour marker offers good prognosis?
ER +ve
What tumour marker offers poor prognosis?
Her-2
Ki67 (proliferation marker)
Surgical treatment for breast cancers?
- Breast conservation (wide local excision or lumpectomy)
- Mastectomy
How do you identify which nodes are involved?
Sentinel node biopsy (technetium 99)
What treatments can be used for the different receptors/tumour markers?
Tamoxifen for ER +ve
Trastuzumab (herceptin) for HER-2 +ve
As part of adjuvant therapy (after surgery) what hormonal therapy can you use hormonal therapy. What can be used in pre and post-menopausal women? Why is it different for post-menopausal women?
pre: tamoxifen
post: aromatase inhibitor (selective oestrogen receptor modulator)
Tamoxifen - risk of DVT + endometrial Ca ^ in post-menopausal
Give a risk of tamoxifen
DVT + endometrial Ca
What characterises paget’s disease of the nipple?
Eczema of nipple
commonest site of mets?
bONE > lungs
Her-2 +ve treatment
Herceptin (trastuzumab)
ER +ve treatment
Tamoxifen