Questions Flashcards
What is fibroadenosis
Fibrocystic disease (NOT FIBROADENOMA)
Benign mammary dysphasia
Lumpy breasts which may be painful
Symptoms worsen prior to menstruation
What is Paget’s disease of the Breast
Eczema like symptoms on nipple and areola
Itchy red rash
Sign of Breast cancer behind the nipple or in Breast tissue elsewhere
Can also get burning sensation and discharge
What is used for er+ Breast cancer in post menopausal women and examples
Aromatase inhibitors eg. Exemestane, letrozole and anastrozole
Who can’t trastuzumab be used in
Patients with history of heart disorders because side effect is cardiotoxicity
Side effects of tamoxifen
Increased risk of endometrial cancer, venous thromboembolism and menopausal symptoms
What is tumour marker for Breast cancer
ÇA 15-3
Commonest cause of blood stained discharge in younger women
Intraductal papilloma - mass is seldom present
What is the Nottingham prognostic index?
Tumour size (x0.2) + lymph node score (0 = 1, 1-3 = 2, more than 3 = 3) + grade score
Interpretation of NPI
2-2.4 - 93% 5 year survival
2.5-3.4 - 85%
3.5-5.4 - 70%
>5.4 - 50%
Details of mucinous carcinoma
2-3% of all Breast cancers
Grey gelatinous surface macroscopically
Better prognosis
Axillary disease is rare
What is comedo necrosis a feature of
High nuclear grade ductal carcinoma in situ
Refers to areas of dead-necrotic Cancer cells - calcification also present
Age of Breast cancer screening
50-70
Being expanded to 47-73
Every 3 years
After 70 women encouraged to make own appointments
What is inflammatory Breast cancer
Rare but rapidly progressive form of breast cancer caused by obstruction of lymph drainage causing erythema and oedema
Usually primary and is managed with chemotherapy
Dissemination occurs earlier - hence could be signs of secondary mets
Details of ductal carcinoma
More likely in post-menopausal women and tends to occur at a single focus within Breast
Details of lobular carcinoma
More likely to have multifocal lesions
Size of fibroadenoma which encourages biopsy
> 4 cm need core biopsy to exclude phyllodes tumour
Details of phyllodes tumour
Fast growing to a large palpable firm mass - fibroepithelial - can have benign or malignant potential
Typically occur in women and 15year older average age than fibroadenomas
What is mondors disease
Superficial thrombophlebitis of the superficial veins of the Breast of chest wall, causes sudden onset pain with swelling and redness - usually linear type lump
Self limiting
Management with NSAIDs
When is MRI good for Breast investigation
Lobular carcinoma - very sensitive for it in same and contra lateral Breast
Can be good for determining treatment
Difference between eczema and Paget’s
Eczema typically bilateral and affects the areola first
Paget’s often unilateral and affects nipple first (pruritus might be absent)
What type of carcinoma is mucinous
Invasive ductal
As is anaplastic
What sort of carcinoma is inflammatory
ductal
Aromatase inhibitors side-effects
Joint/muscle ache
Osteoporosis
Common neurological side effect from breast surgery
Intercosobrachial nerve is commonly sacrificed resulting in an area of numbness on inner, upper arm
What is Cowden’s syndrome
Multiple hamartoma syndrome - rare autosomal dominant syndrome - multiple non-cancerous tumour-like growths (hamartomas)- found in skin, mucous membranes, thyroid and breast tissue
Hamartomas are benign but people with Cowdens are at increased risk of breast, thyroid, endometrial and kidney cancers
Due to mutations in PTEN tumour suppressor gene
What is Li Fraumeni syndrome
Mutation in tp53 tumour suppressor gene which leads to susceptibility for multiple cancers - sarcoma, breast, brain and adrenal = 80% of cancers
90% risk of developing an invasive cancer by age 70 and 50% risk by age 30
Also get leukaemia and lymphoma
What is Muir Torre syndrome
Rare autosomal dominant cancer syndrome - prone to cancer of colon, breast, GU tract and skin
Genes affected = MSH2 and MLH1
Two other syndromes associated with increased risk of cancer including breast
Ataxia-telagiectasia, Peutz-jaegers
