SESAP Breast Flashcards
Is conjugated estrogen therapy after hysterectomy associated with increase in breast cancer risk?
No
How is a decrease in bone density associated with an increase in breast cancer risk?
The Women’s Health Initiative Estrogen Alone Trial post hoc analysis showed that low bone mass = PPV of increase in invasive ER+ breast cancer.
Is increased breast density associated with increase in breast cancer development risk?
Yes.
What % of breast cancer patients report a positive family history?
15-20%.
What gene mutations are associated with breast cancer risk?
BRCA1, BRCA2, p53, ATM, PTEN
What is ATM in relation to breast cancer risk?
ATM= Ataxia telangiectasia mutants. Certain mutants increase the risk of breast cancer.
How is the increase in breast density associated with an increase in breast cancer?
An increase in breast density of mammogram is associated with an increase risk of atypical hyperplasia and in situ breast cancer.
Patients with BRCA1 or BRCA2 mutation should consider what surgeries?
Bilateral mastectomy and bilateral oophrectomy.
What is the differential in an adolescent girl with a large breast lesion?
Giant fibroadenoma, phyllodes tumor, virginal hypertrophy.
What defines a giant fibroadenoma?
> 5 cm
How do giant fibroadenomas usually present?
Firm, rapid doubling time, usually solitary, NONtender.
What is the purpose of breast surgery for cancer?
Identification of cancer, staging and local control.
What is the difference between and macro-metastases and a micro-metastases in a lymph node?
Microscopic met cutoff: 2mm.
What % of patient with a + LN after SNLBx will have more +LNs?
10-20% of the time.
What kind of gene is the HEr2/neu gene?
It is a proto-oncogene.
What kind of receptor is the Her2/neu receptor?
Transmembrane glycoprotein receptor.
What is trastuzumab directed against?
erb-2 extracellular binding domain.
Why is the Her2/neu receptor considered an orphan receptor?
Because there is no epithelial growth factor/ligand that has been identified.
What intracellular pathways are associated with Her2/neu activity?
Cell proliferation, inhibition of apoptosis, cell differentiation and angiogenesis.
How does Her2/neu-R become activated?
It binds to itself or other tyrosine kinase receptors (check this).
What gene is responsible for Her2/neu?
Long arm 17: 17q11.2-q12
How is the Her2/neu gene identified?
Over expression found on either metastatic disease or primary tumor on parafin blocks.
What kind of breast cancer is associated with Her2/neu carriers?
Agressive, short-disease-free interval, high rate of occurrence after adjuvent therapy.
Are Toll-like receptors associated with cancer?
No. They are associated with infections.
