12 - Breast Carcinoma Flashcards

1
Q

how many women are affected by breast carcinoma?

A

1/8 females

accounts for 22% of female cancers

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2
Q

how many men are affected by breast carcinoma?

A

1/870 males

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3
Q

how does breast carcinoma appear in mammogram?

A

soft tissue opacity

microcalcification

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4
Q

how does breast carcinoma appear macroscopically?

A

hard lump

fixed mass

tethering to skin

peau d’orange dimpling of skin

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5
Q

RFs for breast carcinoma?

A

gender

age

menstrual history

age at first pregnancy

radiation

family history

personal history

hormonal treatment

genetics

obesity

lack of exercise

alcohol

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6
Q

what % of breast cancers can be put down to inherited factors?

A

5-10%

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7
Q

BRCA1 gene - % contribution to hereditary breast cancer?

A

20-40%

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8
Q

BRCA2 gene - % contribution to hereditary breast cancer?

A

10-30%

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9
Q

TP53 gene - % contribution to hereditary breast cancer?

A

<1%

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10
Q

PTEN gene - % contribution to hereditary breast cancer?

A

<1%

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11
Q

other genes - % contribution to hereditary breast cancer?

A

30-70%

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12
Q

histological classification - 2 types of 2 non-invasive carcinomas?

A

DCIS - ductal carcinoma in situ

LCIS - lobular carcinoma in situ

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13
Q

histological classification - 3 types of 2 invasive carcinomas?

A

invasive ductal carcinoma (NST)

Invasive lobular carcinoma and its variants

special types

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14
Q

how is in situ carcinoma detected?

A

it’s preinvasive so it does not form palpable tumour -

therefore,

can only be detected using X-ray in DCIS-screening

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15
Q

name 4 special types of breast carcinomas?

A

tubular carcinoma

mucinous carcinoma

carcinoma with medullary features

metaplastic carcinoma

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16
Q

name 5 diagnostic procedures for breast carcinomas?

A

clinical examination

radiology

FNA cytology

needle core biopsy

wide local excision with adequate margins

17
Q

screening for breast cancer - how much does it reduce mortality?

A

30%

18
Q

screening for breast cancer - women at what age?

A

50-70 years

19
Q

screening for breast cancer - how often are mammograms carried?

A

every 3 years

20
Q

mircocalcifications - are they harmful?

A

usually harmless - small % may be pre-cancerous/ cancerous tissue

21
Q

what are the 2 big indicators of breast cancer on mammography?

A

masses

microcalcifications

22
Q

describe 2 routes of LOCAL metastases?

A

skin

pectoral muscles

23
Q

describe 2 routes of LYMPHATIC metastases?

A

axillary nodes

internal mammary nodes

24
Q

describe 4 routes of BLOOD metastases?

A

bone

lungs

liver

brain

25
Q

what is NPI?

A

Nottingham Prognostic Index -

based on tumour size, grade and nodal status

26
Q

what is ER and PR?

A

ER - oestrogen receptors

PR - progesterone receptors

27
Q

what are ER and PR used to indicate?

A

the response to hormonal therapies

28
Q

how does HER-2 relate to trastuzumab?

A

~20-30% positive - predicts response to trastuzumab

29
Q

how to determine management of breast cancer?

A

staging of BC

30
Q

treatment - surgery procedures?

A

mastectomy

breast conserving surgery - WLE

31
Q

other non-surgical treatments?

A

radiotherapy

antihormonal therapy

chemotherapy

32
Q

which drug is used in antihormonal therapy?

A

Tamoxifen