Breast cancer

Question 1

What is the lifetime risk of breast cancer in women in the UK?

Answer 1

1 in 8 women

Question 2

Name 4 modifiable risk factors for breast cancer

Answer 2

Length of breastfeeding (reduces risk).

Use of unopposed oestrogens in HRT (>10-15y).

Nulliparity/late first pregnancy.

Early menarche or late menopause (>55y).

Question 3

What % of breast cancers are linked to inherited susceptibility genes?

Answer 3

12%.

Question 4

Which genes are most commonly involved in hereditary breast cancer?

Answer 4

BRCA1 (52% of hereditary cases).

BRCA2 (32%).

TP53 (3%).

CHEK2 (5%).

Question 5

What are the most common histological types of breast cancer?

Answer 5

Adenocarcinomas (ductal/lobular); invasive ductal (no special type) is most frequent

Question 6

What do ER/PR and HER2 status indicate?

Answer 6

ER/PR+: Better prognosis, endocrine therapy responsive.

HER2+: Aggressive but trastuzumab-responsive.

Triple-negative: Poor prognosis, chemo-sensitive.

Question 7

What is the UK breast cancer screening protocol?

Answer 7

Mammography every 3 years for women aged 50-70y.

Question 8

Name 3 clinical signs of breast cancer.

Answer 8

Breast lump/thickening.

Skin changes (dimpling, erythema).

Nipple inversion/discharge.

Question 9

What is the first-line treatment for localized ductal carcinoma in situ (DCIS)?

Answer 9

Wide excision + post-op radiotherapy (or mastectomy for large lesions)

Question 10

What adjuvant therapies are used for ER+ early invasive cancer?

Answer 10

Tamoxifen (5 years).

±Chemotherapy (if high-risk).

Trastuzumab if HER2+.

Question 11

What is the 5-year survival for Stage 4 breast cancer?

Answer 11

25% (incurable)

Question 12

What does OncotypeDX test predict?

Answer 12

Recurrence risk in ER+HER2− cancer via 21-gene assay (scores: low 0-17, intermediate 18-30, high ≥31).