Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Breast > Breast Cancer > Flashcards

Breast Cancer Flashcards

(64 cards)

Start Studying
1
Q

Risk factors of breast cancer

A
  • female
  • increased oestrogen exposure | early onset of periods or late menopause or nulliparity
  • more dense breast tissue
  • obesity
  • smoking
  • family history of 1st degree relatives
  • combined HRT or COCP
  • BRCA1/2 genes
  • ionising radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What genes are related to breast cancer?

A

BRCA 1 + 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are BRCA genes?

A

Tumour suppressor genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What chromosome is BRCA1 on?
What are they at an increased risk of?

A
  • Chromosome 17
  • breast, ovarian, bowel + prostate cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What chromosome is BRCA2 on?
What are they at an increased risk of?

A
  • chromosome 13
  • breast + ovarian cancer `
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Types of breast cancer `

A
  • ductal carcinoma in situ
  • lobular carcinoma in situ
  • invasive ductal carcinoma NST
  • invasive lobular carcinoma
  • inflammatory breast cancer
  • Paget’s disease of the nipple
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Screen programme for breast cancer

A

Mammogram every 3 years to women 50-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Downsides of breast cancer screening

A
  • anxiety + stress
  • radiation exposure
  • missing cancers > false reassurance
  • unnecessary further tests/treatments on incidental findings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who does NICE say are at an increased risk of breast cancer due to family history

A
  • 1st degree relative with BC under 40
  • 1st degree male relative with BC
  • 1st degree relative with bilateral BC <50
  • 2 1st degree relatives with breast cancer `
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What may be offered to women at high risk of breast cancer?

A

chemoprevention
- tamoxifen if perimenopause
- anastrozole if postmenopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical features of breast cancer

A
  • hard, irregular, painless or fixed lumps
  • lumps that are tethered to skin or chest wall
  • nipple retraction
  • mastalgia
  • peau d’orange
  • lymphadenopathy (especially axilla)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who do NICE recommend a two week wait referral for in suspected breast cancer?

A
  • unexplained breast or axilla lump in pt <30
  • unilateral nipple changes in pt >50
  • skin changes suggestive of breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is involved in a triple assessment of breast lumps ?

A
  • clinical assessment: history + examination
  • imaging: USS or mammogram
  • histology: fine needle aspiration or core biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When would you use MRI scans for breast cancer investigations?

A
  • screening women at higher risk
  • to further assess size + features of the tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the sentinel node?

A

The first lymph node that cancer would spread to

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the types of breast cancer receptors?

A
  • oestrogen receptors
  • progesterone receptors
  • human epidermal growth factor HER2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are triple negative breast cancers?

A

Where breast cancers do not express any of the 3 breast cancer receptors
Worse prognosis as it limits treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who does NICE recommend have gene expression profiling on?

A

Women with early breast cancer that are oestrogen receptors positive but HER2 + lymph node negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where does breast cancer most commonly metastasise to?

A

3Ls + 2Bs
- Lungs
- Liver
- Lymp nodes
- Bones
- Brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is used to stage breast cancer?

A

TNM system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are breast carcinoma in situ?

A

Neoplasms that are contained within the breast ducts + have not spread to the surrounding breast tissue | contained within the basement membrane
Precursor to invasive breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the two types of in situ breast carcinoma?

A

Ductal CIS (most common)
Lobular CIS (higher risk of developing invasive malignancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is ductal carcinoma in situ?

A

Malignancy of the ductal breast tissue that is contained within the basement membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Diagnosis of ductal carcinoma in situ

A
  • asymptomatic
  • detected during mammograms | suspicious micro-calcifications
  • confirmed via biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Management of ductal carinoma in situ
surgical excision with breast conserving surgery or mastectomy
26
What is lobular carcinoma in situ?
Non invasive lesion of secretory lobule of breast that is **confined within the basement membrane**
27
When is lobular carcinoma in situ normally diagnosed?
Before menopause Incidental biopsy finding
28
Diagnosis of lobular carcinoma in situ
- asymptomatic - NOT associated with micro-calcifications - incidental finding during biopsy
29
Management of lobular breast carcinoma in situ
- low grade by monitoring - bilateral prophylactic mastectomy in those with BRCA1/2 gene
30
Lifetime risk of breast cancer in women in UK
1 in 7
31
Types of invasive carcinomas of breast
- invasive ductal carcinoma (most commonly) - invasive lobular carcinoma
32
Surgical treatments of breast cancer
**Breast conserving surgery** or **mastectomy** + axillary clearance
33
Who is breast conserving treatment suitable for?
Individuals with localised operable disease + no evidence of metastatic disease
34
What is the most common breast conserving treatment? What does it involve?
- **wide local excision** - excision of tumour with 1cm margin of macroscopically normal tissue
35
What is axillary clearance?
Removal of all nodes in the axilla > sent for Histological analysis
36
Complications of axillary node clearance
- Paraesthesia - seroma formation - lymphoedema in upper arm
37
What is a risk reducing mastectomy? Who is it suitable for?
- An operation to remove healthy breast tissue in order to reduce the risk of breast cancer development - only suitable for patients at high risk of breast cancer
38
When are hormonal treatments used in breast cancer?
- after primary surgery - in elderly or those unfit for surgery
39
First line hormonal treatments for oestrogen receptors positive breast cancer How long are they typically given for?
- ***tamoxifen*** for pre menopause - **aromatase inhibitors** for post menopause *e.g. anastrozole, letrozole* - 5-10 years
40
What is the mechanism of action of tamoxifen?
- used in pre-menopausal women - **selective oestrogen receptor modulator** - blocks oestrogen receptors in the breast - stimulates oestrogen receptors in the uterus + bones
41
What affect does tamoxifen have?
- reduces risk of breast cancer - increases risk of endometrial cancer - reduces osteoporosis
42
What is the mechanism of action of aromatase inhibitors? Examples
- used for postmenopausal women - aromatase is an enzyme in adipose tissue that converts androgens > oestrogen - after menopause, this is the primary source of oestrogen - **aromatase inhibitors block the creation of oestrogen in adipose tissue** - *e.g. anastrozole, letrozole*
43
Where is the primary source of oestrogen from in post-menopausal women?
The action of aromatase adipose tissue that converts androgens to oestrogen
44
Targeted treatments for HER2 positive breast cancer
- **trastuzumab** (herceptin): monoclonal abx - **pertuzumab** (perjeta): monoclonal abx - **neratinib**: tyrosine kinase inhibitor
45
What can trastuzumab (herceptin) affect + what monitoring is required?
It can affect heart function so initial close monitoring is required
46
Common radiotherapy side effects in breast cancer treatment
- general fatigue - local skin + tissue irritation + swelling - fibrosis of breast tissue - shrinkage of breast tissue - long term skin colour changes
47
Follow up of treated breast cancer
Surveillance mammogram every 5 years
48
What options are there for the time of reconstructive breast surgery?
- **immediate reconstruction** at the same time as mastectomy - **delayed reconstruction**
49
What options are there for reconstructive surgery after breast conserving surgery? (Oncoplastics)
- **partial reconstruction**: using a flap or fat tissue - **reduction + reshaping**
50
What options are there for reconstructive surgery after a mastectomy? (Oncoplastics)
- breast implants - flap reconstruction
51
Downsides to breast implants
- less natural feeling than flap - hardening - leakage - shape change
52
What does a latissimus dorsi flap involve?
- breast reconstruction using a portion of latissimus dorsi + associated skin + adipose - as predicled or free flap - only done for small reconstruction
53
What does pedicled mean?
Keeping the original blood supply + moving tissue under the skin to a new location
54
What does free flap mean?
Cutting tissue away completely + transplanting it to a new location
55
What does a transverse rectus abdominal muscle flap involve?
- breast reconstructed suiting the rectus abdominis, blood supply + skin - as pedicled flaps or free flap
56
What risk does a transverse rectus abdominal muscle flap have?
Increased risk of abdominal hernia due to weakened abdominal wall
57
What does a deep inferior epigastric perforator flap involve?
- the deep inferior epigastric artery with associated fats skin + veins is transplanted from the abdomen to the breast - free flap
58
Does a TRAM flap or DIEP flap have more risks of abdominal hernia?
TRAM flap because muscle is taken or the abdominal wall is weakened
59
How do breast carcinomas in situ most commonly present?
Asymptomatic Incidental findings on screening DCIS on mammogram LCIS on biopsy
60
Breast cancer tumour markers
CA 15-3 ER + PR status HER2 status
61
When is breast radiotherapy advised?
After wide local excision to reduce the risk of recurrence NOT after mammogram
62
What investigation is need in women with non palpable axillary lymphadenopathy at presentation before surgery?
- Pre-operative axillary USS - if negative, sentinel node biopsy
63
What is the most appropriate treatment to downstage a tumour before surgery in women that are node positive?
FEC-D chemotherapy
64
Why do you do USS in women <35 but mammogram in women >35?
Women <35 have denser breast tissue

Breast (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions