Specific Cancer Facts Flashcards
Breast Cancer:
What NEW number of cases (female only) in 2021?
How many deaths?
In 2021:
281,550 new cases of female only breast cancer
43,600 deaths
Breast Cancer:
What are four different structures of the breast and corresponding cancers called?
Lobules (glands that make breast milk) = lobular cancers
Ducts (small canals that come out from the lobules and carry the milk to the nipple) = ductal cancers
Nipple (opening in the skin of the breast where the ducts come together so the milk can leave the breast) and Areola (darker thicker skin surrounding the nipple) = Paget disease
Stroma (the fat and connective tissue surrounding the ducts and lobules) = phyllodes tumor
Name two cancers that can originate in the breast though are generally NOT considered breast cancers
Sarcomas (ie angiosarcoma)
Lymphomas
What are 12 risk factors of Breast Cancer?
1.Early menarche (before 12)
2. Late menopause (after 55)
3. First live birth after age 30
4. Nulliparous
5. Recent hormonal contraceptive use
6. BP (Biopsy Proven) proliferative disease
7. BP proliferative disease with atypical hyperplasia
8. Alcohol intake 2+ drinks/day
9. Obesity
10. 1st degree relative w/ post-menopausal breast cancer
11. 1st degree relative w/ pre-menopausal breast cancer
12. Prior Hx of invasive breast cancer
13. Current hormone replacement therapy use with estrogen and progesterone (5+ years)
14. Inherited gene mutation (ie. BRCA1, BRCA2)
15. High breast density
What are two Primary Prevention methods for Breast Cancer?
- Lifestyle changes (ie. health weight, regular exercise, limit alcohol intake)
- Chemoprevention - high risk individuals increasingly are taking Tamoxifen and Raloxifene to decrease risk
What is one Secondary prevention method for Breast Cancer? What are 3 related controversies?
Screening! is a Secondary prevention method for Breast Cancer
Screening controversies:
1. Variable screening accuracy, access disparity, recommended intervals, methods.
- Though self-breast examination has shown NO benefit in reducing breast cancer mortality, individuals should be aware of any breast changes and promptly seek evaluation if concerned
- Mammography advancements have significantly improved accuracy and breast cancer survival for women 60-69 y/o (and likely for 50-59 y/o)
What are 6 Mammogram accuracy variables?
- Breast tissue (dense vs. fatty)
- tumor characteristics
- facility/imaging device
- technician
- Radiologist
- use of digital mammography or tomosynthesis (3D)
What are 4 Tertiary prevention method for Breast Cancer?
- Ongoing surveillance (of secondary cancers and/or treatment-related complications)
- Chemoprevention (ie if ER(+) SERD/SERM/AI)
If VERY high risk:
- Prophylactic mastectomy
- Prophylactic BSO
Name 3 Early Breast Cancer Signs/Symptoms
- Painless lump
- Thickening
- Peau d’orange (orange peel appearance) caused by lymphedema of the pores
Name 8 Late Breast Cancer Signs/Symptoms
- Nipple retraction
- Nipple discharge
- Nipple elevation (may indicate fixed tumor)
- Change in breast symmetry or contour
- Change in breast color
- Breast dimpling or puckering
- Heat or erythema
- Skin ulceration
What are 7 typical diagnostic and staging exams/procedures for Breast Cancer?
- Mammogram
- US
- biopsy
More likely completed if stage III or IV suspected:
4. CT
5. MRI
6. PET
7. Bone scan
Breast Cancer Staging includes what 7 key pieces of information?
- T
- N
- M
- ER (Estrogen Refceptor) status
- PR (Progesterone Receptor) staus
- HER2 (human epidermal growth factor receptor 2)
- Grade
What are 5 factors that influence Breast Cancer treatment choices?
- Menopausal status
- Stage
- Grade
- ER/PR status
- HER2 status
What is the leading Histologic type of breast cancer?
What % of all breast cancers does this histologic type account for?
Ductal
70-80%
What are 9 Histologic Types of Breast Cancer?
- Ductal
- Lobular
- Medullary
- Tubular
- Mucinous
- Inflammatoriy (clinical diagnosis)
- Metaplastic
- Paget disease
- Malignant phyllodes
What are 3 grades of Breast Cancer?
- Grade 1 = well differentiated
- Grade 2 = moderately differentiated
- Grade 3 = poorly differentiated
What are the most common 3 Molecular markers in Breast cancer?
- ER (Estrogen Receptor) status
- PR (Progesterone Receptor) staus
- HER2 (human epidermal growth factor receptor 2)
What are 2 common Breast Cancer gene profiling assays used?
What treatment decisions do these assays help to determine?
- Oncotype DX 21
- MammaPrint
Help to determine if Chemotherapy will provide an additional survival benefit to endocrine therapy
Name 5 Treatment Modalities used to treat Breast Cancer
- Chemotherapy: neoadjuvant (prior to surgery) & adjuvant (post-surgery)
- Radiation Therapy (local control of disease)
- Surgery
- Hormonal
- Targeted therapies (ie. HER2, EGFR, CDK4/6)
What are 4 most common Breast Cancer Metastatic sites?
- Bone & Bone Marrow (spine/ribs/proximal long bones)
- Liver
- Lung
- Brain
- Chest wall
What is the Second leading Cancer Diagnosis in the US with the highest Mortality rate in both Men and Women?
Lung Cancer
In 2021 what were the new cases and deaths caused by Lung Cancer?
235,760 new cases (about 13% of all cancers)
131,880 deaths (Leading cause of cancer death in M & F, 22% of all cancer deaths)
Name Lung Cancer types
Small cell lung cancer (SCLC)
Non-small cell lung cancer (NSCLC)
What percentage of all lung cancers does Small cell lung cancer (SCLC) comprise?
Small cell lung cancer (SCLC) makes up about 13% of all lung cancers.
What is the largest risk factor for development of Small cell lung cancers (SCLC)?
Smoking tobacco
Is the TNM staging system generally used for Small cell lung cancer (SCLC)?
Perhaps the Veteran’s Administration Lung Cancer Study Group staging (limited vs. extensive) disease is used for SCLC instead of the TNM staging since SCLC is typically centrally located, diagnosed at an advanced stage (fast growing, diffuse, and aggressive), often with metastasis.
What % of Small Cell Lung Cancer (SCLC) present with Limited disease?
What are some disease characteristics of Small Cell Lung Cancer (SCLC) Limited disease?
SCLC Limited disease makes up ~1/3 of new case
SCLC Limited disease is defined as:
1. Disease confined to one lung
2. Below supraclavicular area
3. disease can be included in one radiation treatment field
4. Median survival = 16-24 months
5. 14% 5-year survival rate
What % of Small Cell Lung Cancer (SCLC) present with Extensive disease?
What are some disease characteristics of Small Cell Lung Cancer (SCLC) Extensive disease?
Small Cell Lung Cancer (SCLC) Limited disease makes up ~2/3 of new case
Extensive disease SCLC is defined as:
1. Often involving both lungs
2. Metastasis outside the lungs (brain, bone, liver, and adrenals)
3. Median survival = 6-12 months
4. Long-term survival = rare
What are the typical treatments for Small Cell Lung Cancer (SCLC)?
SCLC treatment usually includes Chemotherapy + thoracic and disease usually responds readily to chemotherapy; however, SCLC most often recurs rapidly.
RT may also be used for:
Prophylaxis and treatment of brain metastases.
What percentage of Lung cancers are Non-small cell lung cancer (NSCLC)?
84% of all Lung cancers are Non-small cell lung cancer (NSCLC).
What are 3 types Non-small cell lung cancer (NSCLC)?
- Squamous cell (often central & vascular = hemoptysis)
- Large cell
- Adenocarcinoma (MOST common, typically peripheral lesions, though can be both)
How are Non-Small Cell Lung Cancer (NSCLC) and Small Cell Lung Cancer (SCLC) staged?
NSCLC = staged with TNM system
SCLC = staged with Veteran’s Administration Lung Cancer Study Group staging (limited vs. extensive) disease
What are 5 Risk Factors for Lung Cancer?
- Cigarette smoking (leading cause) and other combustible tobacco products (cigars, pipes, waterpipes)
- Radon gas (2nd leading cause & #1 leading cause among non-smokers) A direct by-product of radioactive decay of radium-226 present naturally in rocks and soil.
- Second hand smoke (3rd leading cause) 20-30% risk
- Other environmental exposures.
* Occupational (ie asbestos, soot, coal-tar pitch, nickel, chromium, aluminum production plants)
* Air pollution (accounts for 1-2% of lung cancer deaths) - Personal or Family history
In 2023 what 2 populations have the highest smoking rates?
American Indian and Alaska Natives (AIAN)
* Northern Plains (42% adult smoking rate)
* Southwest (19% Men, 15% Women smoking rates)
Fewer quit attempts and slower cessation compared to other racial groups
Native Hawaiians (19.6% smoking rates reported in 2018-2020)
How are education and income linked to smoking rates and Lung Cancer risk?
Higher smoking rates are linked to lower education and lower income levels
What are other factors influence Lung Cancer risk associated with cigarette smoking?
- Quality healthcare access
- Targeted deceptive tobacco product advertising
- Lack of tailored smoking-cessation programs