Breast Cancer

Question 1

Can breast cancer affect men?

Answer 1

Yes, but rarely.

Question 2

How prevalent is breast cancer?

Answer 2

It is the most common cancer in women, affects about 1 in 8.

Question 3

What causes breast cancer?

Answer 3

gene mutation

Question 4

What are risk factors for breast cancer?

Answer 4

• ageing
• genetic predisposition
• hereditary (only 5-10% of cases)
• — 75% of these cases d/t breast cancer BRCA gene 1 and 2, on chromosome 17 and 13 respectively
• – remainder of cases are due to other genes
• hormonal factors:
• – high doses of estrogen, without progesterone, for menopause
• – early menarche (exposed to estrogen from an earlier age)
• – late menopause (longer exposure to estrogen)
• nulliparity

Question 5

Where does breast cancer occur most often (anatomically)?

Answer 5

nearly 50% occurs in the upper outer quadrant

Question 6

What are some types of breast cancer?

Answer 6

• ductal carcinoma in situ
• infiltrating ductal carcinoma
• infiltrating lobular carcinoma
• medullary carcinoma
• colloid carcinoma
• tubular carcinoma
• inflammatory breast cancer
• Paget’s disease

Question 7

Which two types of breast cancer are most common?

Answer 7

• ductal carcinoma in situ (20%)

- infiltrating ductal carcinoma (~75%)

Question 8

What is the pathology of ductal carcinoma in situ?

Answer 8

• intraductal
• non-invasive
• stage 0 (doesn’t mean tumour is not there)

Question 9

What is the pathology of infiltrating ductal carcinoma?

Answer 9

• ductal origin
• solid, irregular mass
• invasive
• proximal metastasis to axillary lymph nodes
• distal metastasis to liver, bone, brain
• often in upper outer quadrant
• malignant cells destroy resident cells and deposit collagen

Question 10

What are manifestations of breast cancer?

Answer 10

• usually unilateral (affects 1 breast)
• fixed, irregular, painless mass
• most often in tail of spence
• in later stages: discharge from nipple, retraction, edema

Question 11

How is breast cancer diagnosed?

Answer 11

• screen using mammography (imaging)
• biopsy
• biopsy should also be examined for surface receptors for estrogen and progesterone
• look for tumour markers, ex. carcinoembryonic antigen (CEA)

Question 12

How is breast cancer treated?

Answer 12

combination of:

• surgery
• chemotherapy
• radiation
• hormone therapy if tumour has lots of receptors for estrogen and progesterone

Question 13

What might hormone therapy for breast cancer consist of?

Answer 13

• giving an anti-estrogen or anti-progesterone (ex. tamoxifen is an anti-estrogen, or use an androgen)
• giving high doses of the hormone to down regulate the receptors

Question 14

What are the different types of surgeries used to treat breast cancer?

Answer 14

• lumpectomy (remove tumour and some surrounding tissue)
• quadrantectomy (remove quadrant of breast)
• mastectomy (remove entire breast, not done very often now)

Question 15

What determines the prognosis of breast cancer? Is it the size of the tumour?

Answer 15

no, rather it is the involvement of axillary nodes that is more significant when determining prognosis