Week 9: Breast, Ovarian cancer Flashcards
Which tumour marker is useful for detecting relapse of breast cancer
Ca 15-3
Levels often raised before clinical signs of cancer
First line investigation for breast mass.
Why is this first line
USS
Tells you if cancer is cystic or solid
Signs on breast of breast cancer
- P’eau d’orange
- Breast lump
- Nipple retraction/ discharge
- Paget’s diseae
Do breast cancer lumps tend to be painful or painless
Painless
Which type of cancer is Paget’s disease
Cancer of terminal ducts
Signs of Paget’s disease
- Eczematoid changes to nipple
- Bloody nipple discharge/ burning/ itching
- Breast lump
Mammography should not be performed in women under what age
don’t do <50yo
What does triple assessment consist of
- Clinical exam
- USS/ mammography
- FNA/ core biopsy
When is a breast biopsy indicated in case of a
- solid mass
- cyst
Solid mass: always, to study cell architecture
Cyst: bloody fluid/ recurrent cyst/ not resolved completely after aspiration
Where is Ca125 produced
derivatives of coelomic epithelium
(pleura, pericadium, peritoneum, fallopiean tube, endometrium, endocervix)
Not found in a normal ovary
Tumour markers are usually not 100% specific.
Which 2 markers can be 100% specific, and in what setting?
- beta-HCG -> 100% specific for prostate cancer
2. Ca125 -> 100% specific for relapse of ovarian cancer (if 2x upper limit of normal)
Most common ovarian cancer.
What epithelium is it made of
Serous
Made of fallopian tube epithelium
Most aggressive ovarian cancer
What epithelium is it made of
Clear cell
Made of gestational epithelium
Tumour markers that should be done in a women <40yo suspected of ovarian cancer
- Ca125
- CEA
- AFP
- betaHCG
- LDH
Tumour markers that should be done in a women >40yo suspected of ovarian cancer
- Ca125
2. CEA
