Breast Conditions - Benign or Malignant Flashcards

1
Q

What is a woman’s lifetime risk of developing breast cancer?

A

1 in 8

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2
Q

What is the lifetime risk predicted to be in 2024?

A

1 in 6

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3
Q

What is different about care in a Breast Care Unit?

A
  • led by specialist breast surgeons
  • triple assessment done (clinical, imaging and pathology)
  • “One stop” clinic
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4
Q

What risk factors can be modified to decrease the risk of breast cancer?

A
  • BMI/weight
  • Exercise/diet
  • Alcohol
  • Smoking
  • Exposure to radiation
  • Having a family and age at which this occurs
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5
Q

How do patients normally present to the breast cancer?

A
  • 50% patients are asymptomatic and picked up at screening
  • other 50% are symptomatic
    => 1/2 of these have a lump
    => Other symptoms = discharge, nipple changes, dimpling, texture/colour change
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6
Q

What percentage of women attending the breast clinic have malignant breast cancer?

A

10%

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7
Q

How many views are used in mammography?

A

4 views

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8
Q

What is the main use of ultrasound in breast cancer clinics?

A
  • To detect density of lump

i. e. solid or fluid

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9
Q

What does T4 staging of breast cancer indicate?

A

Extension to skin or chest wall OR BOTH

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10
Q

Describe the difference between N1-N3

A

N1 - mobile nodes
N2 - fixed nodes
N3 - ipsilateral internal mammary nodes

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11
Q

Describe the Halstedian and Fisherian paradigmns and how these relate to treatment today?

A

Halstedian

  • ALL were treated as local disease
  • Large mastectomies were thought to be curative

Fisherian

  • Considered as a Systemic disease from onset
  • Micrometastases thought to be present at onset
  • Systemic tx is thought to make the only difference

Now we treat locally or systemically depending on extent of disease

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12
Q

What surgery can be used for local disease?

A
  • lumpectomy
  • mastectomy
  • oncoplastic surgery (large excision whilst preserving the breast)
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13
Q

How can oncoplastic surgery be used to preserve the appearance of the breast?

A
  • Bilateral surgery can be undertaken to make breasts appear symmetrical after removal of one lump
  • New breast can be moulded for implant
  • Tissue from elsewhere can be used to mould new breast
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14
Q

Explain how radiotherapy beams spare superficial layers of the breast?

A
  • beams intensify upon reaching target

=> are less intense on more superficial layers

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15
Q

Why does chemotherapy cause various side effects?

A
  • kills all cells in Mitotic phase (replicating)

- including gut, hair follicles etc

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16
Q

What types of non-invasive hormonal therapies are used to treat breast cancer?

A

Selective ER Modulators (SERMs) - Tamoxifen
Aromatase Inhibitors - Letrozole
GnRH Antagonists

17
Q

What invasive hormonal treatment can be used to treat breast cancer?

A

oophrectomy

18
Q

How is HER2 targeted therapy delivered?

A

IV or s/c

19
Q

Why does HER2 targeted therapy cause less side effects?

A

Spares other cells unlike chemotherapy

- cardiotoxicity

20
Q

What type of benign breast disease does ANDI stand for?

A
  • Aberrations in Normal Development and Involuntion of Breast
    e. g. fibroadenoma
  • very mobile
  • present for a few years and may regress
21
Q

At what age to patients normally get cysts?

A

40-50s

22
Q

How do cysts form?

A

milk duct at end of period fills with fluid which doesnt regress

23
Q

Describe the appearance of a papilloma in a breast?

A
  • appears like a skin tag inside the duct (complex cyst)

- if any malignant cells are present then this may cause bloody nipple discharge

24
Q

What endocrine marker should be checked if patients present with nipple discharge?

A
  • prolactin
25
Q

Pain is not usually a symptom of breast cancer. TRUE/FALSE?

A

TRUE

only 2.5% present like this

26
Q

Mastitis, abscesses and fistulae are more common in women who breastfeed and what?

A

Smoke

  • decreased possibility of healing
  • due to poor blood supply
  • cause of nicotine