Breast Cancer Flashcards Preview

Hugh's MD2 Core Conditions and Presentations > Breast Cancer > Flashcards

Flashcards in Breast Cancer Deck (26):
1

Compare LCIS and DCIS prognostically and clinically?

Ductal carcinomas in situ are premalignant and can develop directly into an invasive ductal carcimonas

They present as a lump

 

Lubular carcinomas in situ are only risk factors for the development of adenomas and subsequent malignancies won't necessarily develop at the same site directly

They don't present as a lump

2

What are the medical therapies for breast cancer?

SERM - Tamoxifen 

Herceptin - if HER2 positive

Chemotherapy - Cyclophosphamide, 5FU, Doxyrubicin, Methotrexate

Radiotherapy

3

Which ethnic group have a higher rate of BRA1 and 2?

Eastern European Jew - Ashkenazi

4

What is the recommended breast cancer screening?

1 mammography every two years for women 50-75 years

5

What are the main types of breast cancer?

Ductal carcinoma

Lobular carcinoma

Tubular carcinoma

Mucinous carcinoma

6

What are the two endocrine therapy for breast cancer?

Oestrogen receptor antagonist - tamoxifen

Aromatase inhibitors - eg Anastrozole

7

Why does obesity increase the risk of breast cancer?

It increases the person's exposure to oestrogen

8

How are ductal carcinomas in situ treated?

Wide local excision with adjuvant radiotherapy

No chemo or hormal therapy required

9

What is the mechanism of action of aromatase inhibitors?

Block the conversion of testosterone to oestrogens to reduce the tissue concentration of oestrogen

10

What do intraductal papillary lesions present?

Nipple discharge - sometime with blood

Lump if large enough

11

What must you consider when giving a female patient chemotherapy?

Fertility - Chemotherapy induces menopause

12

What can be used if a patient is Her2 positive?

Herceptin

13

What often precipitates fat necrosis?

Trauma - eg seat belt injury

14

What is tamoxifen?

An oestrogen receptor antagonist

15

When is radiotherapy contraindicated?

When it has been performed previously

When the patient has scleroderma

16

Compare low and high grade carcinomas in situ

Low - Punched out cribiform

- Small regular nuclei

 

High - Large irregular nuclei

- Central necrosis

17

What regimen provides better reduction of risk of recurrence of breat cancer; total mastectomy or wide local excision and radiotherapy?

They are equvalent

18

What lifestyle factors can be modified to reduce the risk of breast cancer reoccurence?

Avoid weight gain

Exercise

 

19

Where does breast cancer metastasize to?

Bone

Lung/liver

Brain 

20

How does fibrocytic disease present?

Lumpy, painful breast

21

What types of biopsies are there for breast Ca?

Fine needle aspirate

Core biopsy

Incisional biopsy

Excisional biopsy

22

What types of cancers on FHx that increase the risk of breast cancer?

Breast cancer

Ovarian cancer

Prostate

Familial gastric cancer

23

What investigations are helpful in breast Ca?

Ultrasound

Mammography

Biopsy

 

24

What is the most likely diagnosis of a new lump in a young woman?

Fibroadenoma

Cyst

Fibrocyst tissue

Cancer

25

What is Paget's disease of the nipple?

DCIS involving the nipple - extending into the epidermis

26

When is total mastectomy indicated?

When the patient is a carrier of a high risk gene - eg BRCA1 or 2

Or when wide local excision and radiotherapy is contraindicated