Tumours of which organs commonly spread to the breast?
Smooth muscle (commonly uterus)
Which malignant skin tumour can spread to the breast?
Breast cancer commonly spreads to which structures?
Which cells are neoplastic in breast carcinomas?
In which specific part of the breast are most carcinomas found?
Apart from the lobules, where else can breast carcinomas arise?
What is meant by an in situ carcinoma?
Hasn’t breached basement membrane
So not invasive (yet)
What are the two specific types of lobular neoplasia?
Atypical lobular hyperplasia (<50% of lobule involved)
Lobular carcinoma in situ (>50% involved)
Invasive carcinoma after that
Lobular neoplasms tend to have oestrogen receptors.
What does this mean?
They grow in response to oestrogen
e.g menstrual cycle, OCP, HRT
20% of lobular neoplasms removed by core biopsy are hiding a more ___ lesion.
so the recurrence rate is really high
How are lobular neoplasms managed?
What happens to the centre of high grade ductal neoplasms (DCIS)?
because growth outpaces blood supply
High grade ductal carcinomas can spread to involve what breast structures?
What is a cancer of the nipple which is highly associated with DCIS?
Paget’s disease of breast
What does Paget’s disease of breast look like?
Eczema around affected area
Which breast cancer is Paget’s disease most associated with?
Is Paget’s disease invasive?
Still a carcinoma in-situ, bound by the basement membrane, but is likely to invade if not cut out
How is DCIS managed?
Surgical excision +/- radiotherapy, chemo, hormones, Herceptin
depends on the makeup of the tumour
Which proteins are commonly found in epithelial tumours and can be stained?
Both lobular and ductal neoplasms have the potential to become which tumours?
Which structure is breached in invasive carcinomas?
What is the most common cancer affecting females?
What is the most common cancer affecting males?
The incidence of breast cancer (increases / decreases) with age.
increases with age
(Increased / Decreased) age is a risk factor for breast cancer.
Increased age is a risk factor for breast cancer
Genetic mutations in which genes are risk factors for breast cancer?
BRCA1 / 2
TP53 (Li Fraumeni syndrome)
When menstrual abnormalities predispose you to breast cancer?
Multiparity is a risk factor for breast cancer - true or false?
Nullparity is a risk factor for breast cancer - true or false?
Which lifestyle factors increase a person’s risk of developing breast cancer?
Which genetic mutations are best known for causing breast cancer?
BRCA1 / BRCA2
Which local structures can breast cancer spread to?
Anterior chest wall muscles
Which lymph nodes does breast cancer commonly spread to?
Axillary nodes (numbered 1 -3 inferior to superior) laterally
Internal mammary (thoracic) nodes medially
Both of these drain to the supraclavicular nodes (which is why you check here in a breast exam)
What are sentinel nodes?
The first lymph nodes which would drain a suspected tumour
What is a sentinel node biopsy?
Excision of the first nodes would drain a tumour to see if they’re positive for cancer
Which type of carcinoma in situ most commonly gives rise to invasive breast cancer?
What is the difference between the
of a tumour?
a) Stage = spread
b) Grade = degree of differentiation
The more differentiated a tumour is, the (better / worse) its prognosis.
because the tumour cells highly metaplastic - not like their parent cells
The more ___ receptors an invasive carcinoma has, the better its prognosis.
because it can be targeted by drugs
Malignant breast tumours possessing oestrogen receptors are susceptible to which treatments?
Malignant breast tumours possessing progesterone receptors are vulnerable to which treatments?
I think it’s just the same as oestrogen receptors
Apart from oestrogen and progesterone, what is another type of hormone receptor which is found in breast cancer?
Which monoclonal antibody is derived from mice and can be used to target HER2 receptors in breast cancers?
Trastuzamab / Herceptin
which can’t be given to pregnant women
Malignant breast tumours possessing HER2 receptors are vulnerable to which treatment?
Trastuzamab / Herceptin
What is meant by the term triple negative when referring to breast cancer?
Tumour cells don’t have oestrogen, progesterone or HER2 receptors
Rendering it harder to treat
Which gene mutations tend to cause triple negative breast cancers?
BRCA1 / 2
Which organs are a common site of breast cancer metastasis because they produce oestogen?
What are the treatment options for invasive carcinomas?
Chemotherapy inc. trastuzamab