Tutorials 5 - 8 - Breast, Bladder, Lung, Lymphoma

Question 1

Outline the breast screening programme

Answer 1

Women aged 47 - 73 - mammogram every 3 years

Question 2

What sort of cancer does a density suggest?

Calcification?

Answer 2

Density - invasive

Calcification - DCIS

Question 3

What sort of cancer is most common in the breast?

Answer 3

Adenocarcinoma

Question 4

What is DCIS?

Answer 4

Ductal carcinoma in situ

Limited to ducts and lobules by BM

Question 5

What is Paget’s disease?

Answer 5

Malignant cells spread to nipple skin without crossing BM

Question 6

What is luminal A?
What is luminal B?
Basal-like?

Answer 6

A = ER +ve, her2 -ve
B = ER +ve only 
Basal-like = ER -ve, PR -ve, her2 -ve

Question 7

What is a germline mutation in p53 called?

Answer 7

Lee-Fraumeni syndrome

Question 8

Where does breast cancer typically met to?

Answer 8

Bone, brain, lung, liver

Question 9

Describe the triple approach to breast cancer diagnosis

Answer 9

• History and examination
• Imaging
• Biopsy

Question 10

What sort of cancer affects the bladder?

Answer 10

Transitional cell carcinoma

Question 11

Give 3 risk factors for bladder cancer apart from sex and age

Answer 11

• Smoking
• Exposure to dyes
• Kidney stones

Question 12

How is bladder cancer diagnosed/treated?

Answer 12

TURBT - Transurethral resection of bladder tumour

Question 13

What type of cancer affects the prostate?

Answer 13

Adenocarcinoma

Question 14

How is prostate cancer graded?

Answer 14

Gleason grading system

Question 15

What are the two major causes of lung cancer?

Answer 15

Smoking - polycyclical aromatic hydrocarbons

Asbestos

Question 16

How are lung cancers classified?

Answer 16

• Small cell
• Non-small cell -
  
  • Adenocarcinoma
  • SCC
  • Large cell

Question 17

What is the most common type of lung cancer?

Answer 17

Adenocarcinoma

Question 18

Which are worse prognostically - small cell or non-small cell lung cancers? Why?

Answer 18

Small cell - very hard to resect so less chance of cure

Question 19

Outline the process of how cigarette smoke causes lung cancer

Answer 19

• Irritates bronchi
• Pseudostratified columnar epithelia metaplase to strat squamous
• Carcinogens within metaplastic regions cause neoplasia

Question 20

What is the main cause of mesothelioma?

Answer 20

Asbestos

Question 21

What is lymphoma?

Answer 21

Malignancy of the lymphoid system

Question 22

How is lymphoma categorised broadly speaking?

Answer 22

Hodgkin

Non-Hodgkin

Question 23

What are the “B” symptoms of lymphoma?

Therefore what is a key DDx

Answer 23

• Weight loss
• Fever
• Night sweats
  TB!