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Flashcards in Breast Cancer Deck (18):
1

Breast cancer facts

1 in 8 women will get it
3rd highest cause of cancer death in UK

2

What are the risk factors associated w breast cancer?

1.Age (greatest factor),
2. Oestrogen exposure incl exogenous hormones
3. Famility history + previous BC
4. Ionising radiation e.g. X-ray therapy, radiotherapy
5. Geographical location (higher in developed countries)
6. OBESITY!

3

What can cause hgh oestrogen exposure?

Early menarche (before 12), late menopause (after 45)
Nulliparity/late first pregnancy (increases ovulatory cycles)
Not breast feeding
Oral contraceptives, HRT (but risk reduced on cessation)

4

Why is breast feeding encouraged?

Reduced oestrogen exposure
Reduces breast epithelial proliferation

5

BRCA mutations + types of breast cancer

BRCA1 --> basal-like BC
BRCA2 --> luminal ER posiive BC

6

Why does obesity increase risk of breast cancer?

Adipose tissue activates pro-survival + pro-proliferative pathways
- IGF1 + insulin signalling pathways
- activation of PI3K pathway
- increases oestrogen
- increases leptin - pro-invasive factor

7

How does alcohol increase risk of breast cancer?

Raised levels of acetaldehyde --> epigenetic changes & increases cellular oxidative stress

8

Types of BC based of histology (3 types)

1. In-situ (ductal + lobular), pre-malignant
2. Invasive (ductal, lobular, tubular, papilary)

9

DCIS vs LCIS

DCIS can progress to invasive type but LCIS can't. LCIS DOES increase risk of invasive

10

BC molecular subtypes

Luminal A (ER+, HER2-) - best survival
Luminal B (ER+, HER2-)
Basal - BRCA1 mutation, lowest survival
HER2+
claudin-low

11

3 stages of BC treatment + management?

1. Diagnosis
2. Surgery
3. Adjuvent therapy

12

How is BC diagnosed?

Triple asessment
-Clinical: inspection + palpation, lymph nodes
-Radiological: mammogram/USS for younger
-Pathological: biopsy/fine needle aspiration

13

What are the 3 treatment options for BC?

1. Neo-adjuvant
2. Surgery
3. Adjuvant

14

Types of neo adjuvant therapy for BC? Why is it done?

1. Endocrine e.g. aromatase inhibitors
2. Chemo
3. Biological e.g. herceptin
Done to shink tumour before surgical excision to reduce risk

15

Types of surgery for BC?

Wide local excision (breast conserving)
Mastectomy
Axillary sentinal node biopsy (then clearance if positive)

16

What are sentinal nodes?

The first lymph nodes cancer may spread to - there are located by injecting blue dye near tumour + looking at which node it goes to first

17

Types of adjuvant therapy for BC?

1. Endocrine - AI, tamoxifen, GnRH antagonists
2. Radio
3. Chemo (usually after radio)
3. Biological e.g. herceptin, TKIs e.g lapatinib

18

Future treatment for BC?

Possible tumour vaccines but need antigens it can target
Possible: HER2, MUC1
Oncolytic viral therapies, gene therapies