Breast Cancer Flashcards
What is key to breast cancer prevention?
early detection
PATHO of breast cancer
Begins as a single transformed cell Grows and multiplies in the epithelial cells that line the mammary ducts or lobules Many forms • May be a palpable lump • May only be evident on a mammogram
Invasive vs noninvasivee BC (+percents)
• Noninvasive
20% –>Cancer remains within the duct
• Invasive
80% –> Cancer spreads into the tissue surrounding the duct
What is a metastasis in relation to BC- most common places?
Cancer cells leave the breast
Most common places for Mets: Blood, Lymph, Bone, liver, lung, and brain
Ductal Carcinoma In Situ (DCIS)
what is it? early or late?
=Early, noninvasive breast cancer
• About 14-50% of these cases will become invasive if left untreated
• Lack biologic capacity to metastasize
Lobular Carcinoma In Situ
what is it? when diagnosed? management?
=Rare cancer that begins in the lobules
–>Not a true cancer – cannot spread/become invasive
• Increases the chance that the breast cancer will develop later
• Typically diagnosed at 40-50 yo
• Management: Observation
Infiltrating/Invasive Ductal Carcinoma (IDC)
what is it? what does it feel like?
= Invasive cancer that starts in mammary ducts and epithelial cells lining the ducts
• Grows into a tissue in an irregular pattern
• May be felt as a poorly defined, irregular lump
• Fibrosis will develop around the lump (dimpling= later in disease)
◦ Peau D’orange
Inflammatory Breast Cancer-
what does it look like/feel like, when do we diagnose it in disease process?
= Highly aggressive, Invasive ◦ Swelling ◦ Pain • Typically diagnosed later in disease, dimpling, peau d'orange • May not show up on mammo • No palpable lump
Triple Negative Breast Cancer
what is it? common in what population?
= Highly aggressive
• Lacks receptors typical to breast cancer
◦ No estrogen receptor
◦ No progesterone receptor
◦ No human epidermal growth factor 21
• Common in females who are BRCA + and pre-menopausal
• AA women are at higher risk compared to other races
Male breast cancer presentation/ considerations
= Less than 1% of breast cancer cases • Typically presents ◦ as hard, painless lump ◦ Sub-areolar ◦ With or without gynecomastia • Diagnosis often delayed
BC risk factors
• Gender- females more likely • Genetics ◦ BRCA 1 ◦ BRCA 2 ◦ 1st degree relative: sister, brother, daughter • ^ Age • Bone density • Early menstruation or late menopause • Atypical hyperplasia • Alcohol consumption • Obesity • Hormone replacement therapy • Oral contraceptives • Null parity • Radiation exposure
When to get screening- high risk vs not
• High risk screening = conversation early- before age of 40, get mammo 10 years younger than when 1st degree relative developed cancer
+MRI/ Ultrasound
- Not high risk= age 40-50, annual mammo
when can you stop getting mammos?
75
whats up with breast exams?
• Self-exams ◦ People should be familiar with their breasts ◦ Report changes • Some lumps are normal Also have provider do it
Females at high risk for breast cancer interventions
- Secondary prevention
- Annual mammos
- Clinical breast exams
- Annual MRI screening
- Prophylactic mastectomy/oopherectomy
- Anti-estrogen chemotherapeutic agents
