S2 - Breast Cancer

Question 1

What is the most common killer among cancers?

Answer 1

Lung cancer

Question 2

What is the most common cancer in women?

Answer 2

Breast cancer

Question 3

What is the most common cancer in men?

Answer 3

Prostate cancer

Question 4

Do most women diagnosed with breast cancer have a previous family history?

Answer 4

No, 85% have no family history of the disease

Question 5

What percentage of breast lumps are non-cancerous?

Answer 5

80%

Question 6

What are some of the possible signs and symptoms of breast cancer besides finding a lump?

Answer 6

• nipple or another part of breast pulling inwards
• dimpling or puckering
• sudden discharge from a nipple
• itchy, scaly sore or rash on the nipple
• localized pain that doesn’t go away
• thickening, redness or darkening of the skin on the breast or underarm area
• “peau d’orange” orange peel effect
• unusual swelling and warmth, or a change in breast size or shape.

Question 7

True/False. Self-breast exams are the gold standard for breast cancer detection.

Answer 7

False. They are not even recommended.

Question 8

What percentage of women have dense breasts?

What causes a breast to be considered dense?

In what age group is the breast typically denser?

Answer 8

~40%

A larger presence of fibroglandular tissue (lactiferous lobules and ducts); as opposed to adipose tissue

Younger women (as their breasts are preparing for lactation)

Question 9

What is the best breast cancer detection tool we have?

Answer 9

Mammography (x-ray of the breast)

Question 10

Is it more difficult to detect breast cancer via mammography in a dense or non-dense breast?

Is breast density related to breast size?

Answer 10

Dense breast tissue ‘shields’ the tumor from detection.

No, there is no relation.

Question 11

What are some risk factors for breast cancer?

(Gender? Age? Genetics? Estrogen exposure?)

Answer 11

Gender - much more common in females

Age - more common as age increases

Genetics - BRCA1 and BRCA2 (BReast CAncer genes) genes

Any increase in estrogen exposure - Nulliparous, no breastfeeding, early menarche, late menopause (Estrogen stimulates breast growth)

Question 12

A woman finds a lump in her breast. What are some possible causes of this lump?

Answer 12

A cyst - fluid-filled space

Fat necrosis - usually due to trauma

A benign tumor - fibroadenoma

A malignant tumor (cancer) - adenocarcinomas (much more common) and fibrosarcomas

Question 13

Where is breast cancer more commonly found in the breast (by quadrant)?

Where in the anatomical structures of the breast is it more common (the milk lobes, the ducts, the supporting tissues)?

Answer 13

Upper outer quadrant (armpit area)

The ducts

Question 14

Which race is most commonly diagnosed with breast cancer?

Which race most commonly dies of breast cancer?

Answer 14

Caucasian women

African-American women

Question 15

When is breast cancer awareness month?

Answer 15

October

Question 16

The BRCA 1 gene is associated with which types of cancer?

Answer 16

Breast, ovarian, and uterine cancers

Question 17

The BRCA 2 gene is associated with which type of cancer?

Answer 17

Mainly breast cancer

Question 18

What does it mean for a breast cancer to be triple-negative?

Is this a more or less dangerous form of cancer?

Answer 18

The breast cancer cells have no receptors for estrogen (E), progesterone (P), or human epidermal growth factor (HER-2)

This type of cancer is not responsive to hormone therapy and thus more dangerous

Question 19

How much earlier can mammogram detect breast cancer than self- or clinical breast examination?

Answer 19

2 years

Question 20

Which lymph nodes drain the breast?

Answer 20

The axillary lymph nodes

Question 21

What is the name of the first lymph node to drain the fluid surrounding a tumor?

Answer 21

The Sentinel node

Question 22

What are the ACS guidelines for mammography?

Answer 22

Annual screening for women from 45-54 years of age

Biennial screening for women ≥ 55 years of age

Question 23

What are the USPSTF recommendations for mammography?

Answer 23

Biennial screening after 50 years of age

Question 24

When should a woman begin breast cancer screening earlier than the average recommended guidelines?

Answer 24

When she has a higher risk

• Personal or family history
• Genetic susceptibility
• History of chest radiation (e.g. past TB patients)

Question 25

Describe fibrocystic disease in the breast.

What age group does it typically present in?

Answer 25

Most frequent breast lesion.

Painful, multiple bilateral masses that worsen in pain and increase in size during premenstrual cycle

Most common in women aged 30-50

Question 26

How can breast cancer be treated?

Answer 26

Depends on the extent of the disease growth.

Lymph node dissection

Lumpectomy

Mastectomy

• Simple
• Partial
• Total
• Radical Halsted
• Modified-radical