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Flashcards in Breast Deck (20):

What does triple negative breast cancer mean?

ER negative
PR negative
HER2 negative


What are the three components of the triple assessment?

Clinical assessment and examination
Needle biopsy - usually core but sometimes FNA


What is tamoxifen?

Originally designed as an OCP - tamoxifen is a selective oestrogen receptor modulator. This is used to treat ER positive cancers by blocking the receptors and stopping growth of the cancer.


What is letrozole?

An aromatase inhibitor.
It prevents the conversion of androgens to oestrogen.
It is only effective in post menopausal women


What is fulvestrant?

A SERM licenced for post-menopausal women. It is given by IM injection 1x a month


What is trastuzumab?

A drug that targets HER2 on the cancer cells.
Patients must have LVEF assessed with echo prior to and during treatment.


What is denosumab?

A monoclonal antibody that inhibits the RANK ligand. This is used in bony metastatic breast cancer.


What are the side effects of denosumab?

Osteonecrosis of the jaw?


What are the indications for mastectomy?

Multifocal disease
Local recurrence
DCIS >4cm or a wide area with pre cancer changes


What are the side effects of tamoxifen?

endometrial thickening
menopausal symptoms


What are the risk factors for developing breast cancer?

Increasing age
Early menarche
HRT use


What is Paget's disease of the nipple?

an eczematous change of the nipples associated with an underlying breast malignancy.
Present in 1-2% patients with breast cancer


What is inflammatory breast cancer?

Cancerous cells block the lymph drainage resulting in an inflamed appearance of the breast.


What is a fibroadenoma?

Common in women under the age of 30 - discrete, non-tender, highly mobile lumps


What is fibroadenosis?

Most common in middle aged women - lumpy breasts which may be painful. symptoms are worse before menstruation


What is mammary duct ectasia

Dilatation of the large breast ducts
Most common around the menopause
may present with a tender lump around the areola with or without green nipple discharge
if it ruptures - may cause a local inflammation also known as plasma cell mastitis


What is a duct papilloma?

There are local areas of duct proliferation in large mammary ducts
These are hyper plastic lesions rather than (pre) malignant
they may also present with blood stained discharge


What is fat necrosis of the breast?

This is a condition more common in obese women with large breasts.
It may follow trivial trauma
there is an initial inflammatory response causing a firm and round breast lump. This is rare and may mimic breast cancer especially if it transforms into an irregular lump


What is a breast abscess?

This is more common in lactating women
It presents with a red, hot and tender swelling


What is lactational mastitis?

An inflammatory condition of the interlobular connective tissue that affects approx 10% breastfeeding women. The main cause is the overproduction or incomplete removal of milk leading to milk stasis