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PBL > Unit 2 Case 1 > Flashcards

Unit 2 Case 1 Flashcards

1
Q

What is Unit 2 Case 1 about?

A

A 35-year-old mother finds a lump on her breast. She has a family history of breast cancer. She has an ultrasound and examination which leads to a biopsy. The biopsy is normal with no sign of cancer.

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2
Q

What differences can be observed between normal and abnormal breast tissue?

A

Change in look/feel of the breast or nipple

Nipple discharge and pain are common signs of breast cancer

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3
Q

How does the menstrual cycle affect breast cancer development?

A

During the menstrual cycle levels of estrogen and progesterone increase
Estrogen and progesterone cause stimulates cell growth
Higher exposure may increase cancer risk

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4
Q

What is menopause?

A

Where a woman stops having periods.

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5
Q

What is skin dimpling?

A

When the skin looks uneven and pitting- like orange peel

Can be a sign of breast cancer

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6
Q

What are the genetic factors contributing to breast cancer?

A

The mutation of the BRCA 1 and BRCA 2 gene.
This gene mutation is an autosmal dominant condition
Greatly increase risk of breast cancer

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7
Q

What is a fibroadenoma?

A

A benign tumour of glandular tissue. Usually a lump under the skin

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8
Q

What are the different types of fibroadenomas?

A

Complex fibroadenomas
Juvenile fibroadenomas- comomon in adolescents
Giant fibroadenoma
Phyllodes tumour- usually benign but can turn cancerous so removed.

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9
Q

What are the risk factors for breast cancer?

A

Age (older) , early onset of menstruation (period at a young age), late menopause, mutated BRAC1 and BRAC2 gene

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10
Q

How does estrogen and progesterone increase risk of breast cancer?

A

Cancer cells can have estrogen and progesterone recpetors

When estrogen or progesterone binds to these receptors it causes the growth of the cell

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11
Q

What is PR-positive breast cancer?

A

Breast cancer cells with progesterone receptors on it

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12
Q

What is ER-positive breast cancer?

A

Breast cancer cells with estrogen receptors on it

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13
Q

What are the main early signs of breast cancer?

A

A new lump, irritation or dimpling of breast tissue, nipple discharge, change in shape/size of breasts, pain

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14
Q

How is breast cancer monitored ?

A

Using mammograms and ultrasounds

Or if diagnosed- regular physical examinations aswell

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15
Q

What is a mammogram and why do they use it?

A

An x-ray of the breasts to screen for cancers too small to see

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16
Q

Are some age groups automatically invited to a mammogram?

A

As the likelihood of breat cancer increases with age, women ages 50-71 are automatically invited to breast cancer screening every 3 years

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17
Q

What is a biopsy?

A

A biopsy is where a small sample of cells is taken from breast tissue and analysed to see if its cancerous

18
Q

What are the main 2 types of biopsy?

A

Needle aspiration

Needle biopsy

19
Q

What is a needle aspiration?

A

Use a small needle to extract a sample of cells without removing tissue
-can also drain a benign cyst

20
Q

What is a needle biopsy?

A

most common type

Sample of tissue taken from breast using a large needle

21
Q

What are common types of breast cancer?

A

carcinoma in situ
invasive ductal carcinoma
imflammatory breast cancer

22
Q

What does in situ mean?

A

The abnormal cells that are only found in the place where they first formed in the body

23
Q

What are the common treatment options for a fibroadenoma ?

A

Lumpectomy

Cryoablation

24
Q

What is a lumpectomy?

A

The surgery to remove cancer of abnormal tissue from the breast

25
Q

What is cryoablation?

A

A cryoprobe is inserted into the fibroadenoma which releases a gas to freeze and destroy the tissue

26
Q

What does a triple assessment consist of?

A

History and examination
Imaging
Histology

27
Q

Why is the triple assessment used?

A

Allows for the early and rapid detection of breast cancer

28
Q

What information do they obtain at each stage of the triple assessment?

A

History- risk factors, family history etc
Examination- any abnormal breast or lymph nodes
Imaging- ultrasound
Histology- biospy

29
Q

What is a lesion?

A

Damage or any abnormal change in this tissue of the organism, usually caused by disease or trauma

30
Q

What is the 2 week wait referral?

A

Anyone showing symptoms of breast cancer will be offered an appointment with a specialist within 2 weeks
(legal right)

31
Q

What is informed consent?

A

A competent patient making a voluntary and fully informed decision whether to undergo a procedure

32
Q

What is meant by the term capacity in a patient?

A

The patients ability to understand information and make an informed decision and communicate that decision

33
Q

What is autonomy?

A

The abilily of a patient to act in their own best interest

34
Q

Why may people aviod going to the GP?

A

For a number of reasons, which could be a lack of education of the symptoms, not percieving the symptoms as a threat etc.
Described by the health belief model

35
Q

What is the health belief model?

A

A model that predicts behaviour regarding their own health. Predicting how a patient will act depending on their own perceived barriers, benfits, self-efficacy and threat.

36
Q

What is the role of breast cancer campaigns?

A

Educate and raise awareness of the signs and symptoms of breast cancer to help people catch it earlier and increase the chance of effective treatment

37
Q

What is the NHBCH and what is the aim of it?

A

National heriditary breast cancer helpline
The aim of it is ensure those worried about their family history of breast cancer are supported and have access to full information on all the options available to make an informed decision.

38
Q

What are the options available for someone with family history of breast cancer?

A

Genetic screening once the indiviual is 18

-to identify any mutated genes inherited

39
Q

How reliable are sources from the internet?

A

Not reliable -information online can be edited and is sometimes factually incorrect or not credible.

40
Q

What are the pros of patient internet research?

A

Can confirm or expand on information provided by a health professional
Can help a patient come up with a list of questions to ask during a consultation

41
Q

What are the cons of patient internet research?

A

Not accurate or reliable

Not tailored advice to the patient

42
Q

What are the NICE guidelines for being admitted to the 2 week wait?

A
  • over 30 and have an unexplained lump
  • over 50 and have an abnormal nipple
  • any age that has breast changes which suspect breast cancer
  • if you are over 30 and have a lump in your axilla

PBL (12 decks)

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