The Physiology Flashcards
List the three main types of tissue that is present in the breast, what each subtype
of them is and where they are found
- Glandular tissue 1)15-20 lobules responsible for producing milk, within the lobules we have alveoli- modified sweat galnds which can secrete milk,glandular tissue have receptors for oestrogen and progesterone – which are released by the ovaries and prolactin released by the pituitary gland
- The stroma- which contains adipose- fat tissue and makes up the majority of the breast
- Lymphatic vessels are found just under the skin of the breast- they drain lymph - cellular waste and WBC
What is BRCA and list one fact
Breast cancer is the uncontrolled grown of epithelial cells in the breast – forms a tumour- its makes up 15% of cancer cases and 1 in 8 women are diagnosed with it
What are the subtypes of BRCA
DCIS – ductal carcinoma in situ- the tumour grows from the wall of the ducts into the lumen. If left untreated could get into the basement membrane .DCIS invades other tissue
LCIS- Lobular carcinoma in- situ – clusters of tuour cells that grow within the lobules and cause the alveoli to enlarge – ducts are not invaded.LCIS doesn’t invade other cells.
In what percentages would you find each one
75% is ductal, 15% is lobular
Explain the relation between breast cancer and hormone receptors
Some breast cancers have hormone receptors which allows them to grow in the presence of hormones
What are the 3 kind of receptors present, explain what HER 2 , ER and PR are
It indicated that the tumour is hormone dependent and so it is likely to respond to hormone therapy treatment and so the prognosis is far more favourable
Her 2 is a transmembrane tyrosine kinase which regulates growth,survival and migration so if a cancer is her 2 positive its more aggressive and the prognosis is not as favourable
Explain the luminal table grid
Luminal A is when it is a DCIS with positive hormone involvement but negative her 2 involvement and 15% involvement with a p53 mutation, the treatment would likely be chemo, radiation and hormone therapy
Luminal B Positive hormone, positive her 2, 30% p53 mutation and treatment is also chemo, radiation and hormone therapy.
Triple negative – would mean that they are all negative most having a brca1 mutation – treatment would be chemo, radiation and biological but non her 2 related treatment.
Her 2 type- 70% is her2 positive, 30%is her 2 negative- with 75%of the mutation being a p53 mutation. It requires biological her 2 targeted treatment.
What are the breast cancer risk factors?8
There are 8 risk factors factors for cancer, being 60 years old, median age for diagnosis is between 60-65
Oestrogen exposure – from things like late menopause, the use of oral contraceptives and early menarche – first menustartion
Genetics – BRCA 1 AND 2 – play a role in dna repair, mutations in these confer to 80- 90% lifetime risk
ERBB2 – HER2- receptor tyrosine- protein kinase
Ethnicity – more common in the whites
Obesity, smoking and alcohol use
nulliparty and not being able to have children
Stress- which initates DNA damage
Socio- economic status- less common in deprived population. BREAST FEEDING AND PHYSICAL EXERCISE CAN HELP REDUCE RISKS
What are the screening points for breast cancer?
Mamography is a type of xray that offered to women from ages of 50-70, 1/100 women in the uk have detected it through screening, 8 in 10 are invasive cancers.80% of ammograms detect it when its there, 20% don’t .10% give a false cancer diagnosis.
What is the presentation of breast cancer?
Can be present in different ways- including: Hard painless lump or swelling, swelling under armpit – indicating it has spread to the lymph nodes,breast is immobile, dimpliling and thickening and a change in colour to skin which indicated lymphatic vessels and involvement of skin,retraction or inversion of the nipple, caused by fibrosis of lactiferous ducts
How can we diagnose breast cancer and what are the steps that are taken?
Breast cancer does not cause pain until it spreads to the surrounding tissue, the median age for diagnosis is 60-65. Mamography is used to confirm it – dcis
Breast biopsy susing methods like needle aspiration,ultra sound guided,stereotactic or open
Open biopsy- lumpectomy – all/part of the breast are tested for malignancy Breast ultrasound – helps identify whether the lump is solid or fluid filled Breast MRI – helps identify the breast lump or evaluate abnormal changes to mammogram
FBC,LFT, BONE PROFILE – help with diagnosis and evaluate the invasive nature CT,CAP and bone scan if high risk to show whether it has spread elsewhere.
What is pagets disease
Discharge from the nipple
What is the probability of getting breast cancer?
For a 40-50 year old it is 7.47%
Who is likely to not be happy from treatment of cancer, list them?
People with
other conditions that are long term other than cancer, the lgbt community, ethnic
minorities, those in London hospitals
Classification- List the TNM staging process –
Tumour,node and metastatsis.
