Unit 16 Flashcards
what is the most common ca in women
breast
et of breast ca
mutation of gene rt cell prolif
risk fact for breast ca 4
aging
genetic predispostion
inhereted gene def
hormones
how is aging a risk for breast ca
inc risk in older women rt to cumulativie exposure
how is genetic predisp a risk for breast ca
pt has inc susceptibility to risks, no identifiable gene
how many women does inherited gene def affect
5-10 out of every 100
what percent of the 5-10 out of every 100 women have an inherited gene that they pass onto offspring
75
what are the 2 inhereited gene defs in brst ca
brca1 on chr 17
brca2 on chr 13
what type of genes are brca1 and 2
tumor supressing genes
how do brca1 and 2 pass onto offpsring
autosomal dominatn
what hormone issue is the most important when looking at breast ca risks
excessive in the absense of P after menopause
when is E given to women without P
after menopause, normally given to tx the sudden drop in E prod by ovary to dec SEs of women
which conditions may lead to prolonged E exposure in women
early menarche, late menopause
how is early menarche determiend
based on population norms
what other ‘condition’ may lead to inc E exposure lt inc bc risk
nulliparity
why is nulliparity a risk for bc
uninterupted and repeated meneses means continuous E prod
what things break the E cycle
pregnancy
lactation
bc pill
where does 48% of bc occcur
near tail of spenec in outter upper q of breast
after tail of spence, in what areas does bc have inc incidence in
areola, UIQ, LOQ, ILQ
2 main types of bc
ductal carcinoma in situ
infiltrating ductal carcinoma
what type of cells are involved in ductal carcinoma in situ
inc in epith cells
“in situ” when speaking about ductal carcinomas
restricted, remains in site of origin, non invasive, good prognosis
what fraction of all bc does ductal carcinoma in situ make up
1/5
site of orgin of ductal carcinoma in situ
intraductal
stage O in ductal carcinoma in situ
early stage that can progress to infiltrating ductal carcinoma if left untx
where does infiltrating ductal carcinoma arise from
alone or from ductal carcinoma in situ
what percent of bc does infiltrating ductal carcinoma make up
75%
origin of infiltrating ductal carcionma
ductal origin
what type of mass is in infiltrating ductal carcinoma
solid, irregular mass
what are the 2 types of mets that arise from infiltrating ductal carcinoma
proximal
distal
proximal mets in infiltrating ductal carcinoma
spreads short distance, axilla via lymph v
distal mets in infiltrating dutal carcinoma
liver, bone, brain, via blood
what does infiltrating ductal carcinoma do to breast tissue
destroys it
what percent of bc is identified by pt
60-75%
what mass is usually identifed by the pt
unilateral, immobile, hard, painless mass usually in uoq
late mnfts of breast ca
nipple discharge and retraction
breast edema
dx bc
px hx
mammography
mammography
xray that can detect early tumors
issues with mammograms
may have false + or -
limitations of age and freq of exams
what happens if a mammogram is positiveee
biopsy to determine if its malignant or benign
remove mass
what cell receptors do they look at in cell biopsys from bc
E and P
what does the number of E and P receptors on a cell determine
how dependent a cell is on E and P
why is e and p dependency helpful
we want to know what these malignant cells are receptive to
tx for bc
combo H therapy with combo sx radition chemo
when do we use H thearpy to tx bc
if e and p receptor levels are inc on cell
if E > P in cell r eceptors, what tx do we use
anti estrogen
inc dose of E without any P
androgens
eg of an antiestrogen
tamoxefin
why will inc an E dose without P tx E>P breast ca
inc E will down regulate the number of receptors for that H. Inc e -> damage to receptors killing them
if P>E what tx do we use
progestins
3 sx used in bc
lumpetctomy
qaudrectomy
mastectomy
where do we radiate in bc
breast and axilla
when do we use chemo in breast ca
pre and post sx, circumstantially
what is prognosis of bc bsaed on
node involvement. a whole infected breast has better prognosis then a bit of breast and some lymph node
