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Repro. Med 4 > Breast CA > Flashcards

Breast CA Flashcards

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1
Q

Breast CA is the ___ most common CA in women and the ___ leading cause of CA death in women

A

2nd

2nd

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2
Q

___% of women dx with breast CA have no identifiable risk factors

A

70%

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3
Q

5-year survival is ___% for localized dz (Stage 0 or 1)

5-year survival only ___% once it has spread to other organs (Stage 4)

A

100%

20%

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4
Q

What are unalterable RF for developing breast CA? (FYI)

A 
age 
FHx
race
DES (medication)
Radiation
Genetic Factors 
menstrual hx 
reproductive hx
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5
Q

What are controllable factors for breast CA (FYI)

A 
obesity/diet
exercise
no breast feeding 
alcohol
hormone replacement therapy
BC reproductive hx
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6
Q

What is the “most important” RF for breast CA?

A

age

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7
Q

Gail-NCI Model is a risk calculator for what?

A

breast CA

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8
Q

__-___% of Breast CA related to inherited factors (BRCA1/2)

A

5-10%

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9
Q

What are RF associated w/ BRCA mutations?

A 
multiple cases of early onset breast CA 
ovarian ca with FHx of breast CA
Ovarian and breast CA in the same woman
b/l breast CA 
Ashkenazi jewish jeritgae 
male breast ca
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10
Q

What is the risk of breast CA in women w/ BRCA-1?

A

50-85%
2nd primary breast CA (40-60%)
ovarian CA 15-45%

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11
Q

What other CA are associated w/ BRCA 1?

A

prostate

colon

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12
Q

What are examples of breast CA prevention?

A

Clinical Breast Examination
Screening mammography
Chemoprevention
Surgical prophylaxis

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13
Q

When should a woman perform her self breast exam if premenopausal?

A

7-8 days post menses

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14
Q

__% of breast masses found by pt! (most non-malignant)

A

90%

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15
Q

___ is a woman’s awareness of the normal appearance and feel of their breasts

A

Breast Self Awareness

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16
Q

When should clinical breast examinations begin?

A

Age 20-39 every 1-3 years

Age 40 and older annually

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17
Q

When is screening mammography recommended?

A

Annually >40 y/o
Or 10 years prior to youngest relative age at dx
Recommendations >75—studies inconclusive

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18
Q

If BCA positive

Monthly breast self-examinations should begin at ____ y/o

Semiannual clinical breast examination beginning at ____ y/o

Annual mammography and breast MRI beginning at ____ y/o or earlier depending on FHx

A

18 y/o
25 y/o
25 y/o

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19
Q

T/F: Mammograms do not save lives

A

F, duh.

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20
Q

T/F: Women w/ breast implants should not have a mammogram because the implant may pop

A

F (but MRI is usually gold standard)

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21
Q

What medications are used for chemo-prevention of breast CA? (x3)

A

tamoxifen
Raloxifene
Aromatase Inhibitors

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22
Q

Using tamoxifen can reduce invasive breast CA up to ___%

A

50%

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23
Q

What are the risks and side effects of using tamoxifen?

A 
increased endometrial CA and DVT
cataracts
depression
vasomotor symptoms
vaginal dryness/discharge
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24
Q

What are the side effects of raloxifene?

A

less ute CA
TE events
cataracts
improved bone density

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25
What is raloxifene FDA approved for?
prevention of osteoporosis
26
What are the side effects of Aromatase Inhibitors?
osteoporosis vasomotor sx joint pain depression
27
What are surgical prophylaxis options of breast CA?
Prophylactic mastectomy Prophylactic bilateral salpingo-oophorectomy (BSO) **need Genetic testing of high risk women
28
___% presenting complaint in breast CA is painless breast lump ___% breast masses found by pt on SBE ___ is location of ~60% of breast CA
70% 90% UOQ
29
What is included in the CLINICAL exam of breast CA?
inspection | palpation (breast and lymph noses)
30
What are s/s of breast CA?
- painless lump or thickening in breast - d/c or bleeding - change in size or contour of breast - change in color or appearance of areola - redness or pitting of skin over the breast
31
What is the most common s/s of breast CA?
Painless lump or thickening in breast
32
What imaging studies do you use in the work up of breast CA?
mammogram US (MRI)
33
____ is performed by compression aided radiographic study of the breast. It is the most reliable means to detect breast CA before _______ is present
Mammography | palpable mass
34
Slow growing tumors can be identified __ or more years before palpable w/ a mammogram
2
35
T/F: A palpable mass needs biopsy regardless if it is seen on mammogram or not
T
36
What are the different types of mammography?
Digital mammography Computer assisted detection (CAD) 3-D mammography (tomosynthesis)
37
What are characteristic findings of breast CA on mammography?
calcifications masses ill-defined
38
What does BI-RADS stand for? Why is it used?
Breast Imaging Reporting and Data System Standard way to describe mammogram findings and results Also describes breast density
39
What is the grading system of BI-RADS?
0-6 (inconclusive to obvious malignancy)
40
T/F: The probability of CA is not directly related to BI-RADS assessment
F: Probability of CA IS directly related to BI-RADS assessment
41
What characteristic of a breast tissue can make is more difficult to detect breast CA?
More glandular tissue, less fat | **CA can be hidden
42
What is the main purpose of using breast US?
differentiating cystic from solid mass | US guided aspiration of cyst
43
How do you evaluate the pathology of breast CA?
FNAC (fine needle aspiration cytology) Biopsy: Excisional, Core Bx
44
What are examples of different breast CAs?
Ductal Carcinoma in situ (DCIS) Invasive Ductal Carcinoma (IDC ) Invasive Lobular Carcinoma (ILC)
45
What are characteristics of invasive breast CA?
CA cells invade blood vessels | CA cells invade lymph duct
46
What is the TNM system used for? What does it stand for?
Breast CA staging T=tumor N=regional lymph nodes M=distant metastases
47
Describe stage 0-4 breast CA (FYI?)
Stage 0 --carcinoma in situ Stage I – tumor < 2 cm, no nodes Stage II—tumor 2-5 cm, +/- nodes* Stage III – locally advanced disease, fixed or matted lymph nodes and variable tumor size** Stage IV – distant metastases (bone, liver, lung, brain)
48
What factors are considered when establishing a prognostic value for a woman w/ breast CA?
``` Age/menopause status Tumor sz histological grade histological tumor type axillary lymph node involvement Distant mets Steroid receptors status ```
49
What is the primary therapy for breast CA?
Surgical resection followed by adjuvant radiation and/or chemotherapy Neoadjuvant therapy - Chemo to shrink large tumors pre-op to allow lumpectomy instead of mastectomy
50
What are some after breast CA tx effects?
``` Risk for local/distant recurrence, new primary CA—need for close follow-up Lymphedema of upper extremity “Chemo-brain” Menopausal symptoms Osteoporosis, cardiovascular issues ```
51
Paget carcinoma occurs in ____%, in the ____(anatomical location)____
1% | nipple
52
What are sx of paget carcinoma?
itch/burn/superficial erosion of nipple | looks innocuous
53
Why is the dx of paget carcinoma difficult?
often missed or delayed treated for dermatitis or infection
54
____ occur is in <3% of breast CA and is the most malignant for of breast CA
Inflammatory Carcinoma
55
What are the sx of Inflammatory Carcinoma?
(RED, HOT BREAST) rapidly growing painful breast inflammatory changes sometimes a mass
56
What is Inflammatory Carcinoma most commonly mistaken for?
mastitis
57
Breast CA during Pregnancy and Lactation dx is often delayed, but should you work up a breast mass even if the women is pregnant?
yes | 1/3000 pregnancies
58
For women w/ an augmented breast, capsule contracture/scarring occurs in ___-___% Implant rupture in __-__%
15-25% | 5-10%
59
____ _____ is palpable enlargement of male breast, it may be asymmetric or unilateral and is occasionally tender
Benign Gynecomastia
60
What is the tx for Benign Gynecomastia?
tx underlying cause | Rx or surgical reduction if ongoing and symptomatic
61
What are RF for male breast CA?
age prostate CA hyperestrogenic BRCA2 +
62
Is prognosis for male breast CA better or worse than women?
worse than women, dx late/mets

Repro. Med 4 (7 decks)

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