breast cancer Flashcards
(43 cards)
PP of breast cancer
malignancy primarily of the milk ducts or lobules, which produces the milk
what is significant about BC?
Most common non-skin malignancy in women → 2nd most common cause of cancer death after lung → 1 in 8 lifetime incidence
RF for BrCA?
75% have no RF
BRCA1 & BRCA2
age >65 yo (50%)
hormonal (increased number of menstrual cycles)
increased estrogen: postmenopausal HRT, obesity, etoh
hormonal RF for BrCA?
Nulliparity, 1st full term pregnancy >35 yrs, early onset menarche (<12yrs), late menopause, prolonged unopposed estrogen, never having breast fed
types of BrCA?
ductal carcinoma
lobular carcinoma
Medullary, Mucoid, Tubular, Papillary, Metastatic, Mammary Paget’s Disease of the Breast
what is the MC form of BrCa?
Infiltrative ductal carcinoma
what is infiltrative ductal carcinoma associated with?
Mets- axillary
what is the other type of ductal carcinoma?
Ductal carcinoma in situ: doesn’t penetrate the basement membrane
types of lobular carcinoma?
infiltrative and lobular carcinoma in situ (May not progress but associated with ↑risk of invasive breast cancer in either breast)
s/sx of br ca
Breast Mass → Usually painless, hard, fixed (non-mobile) lump → May be mobile early on
+/- axillary lymphadenopathy
Unilateral nipple discharge → +bloody, purulent or green
what breast quad is mass mc found?
Upper Outer Quadrant (65%), areola (18%)
common areas of br ca mets?
lungs, liver, bone, brain
PE findings of breast ca
skin changes
Pagets dz of nipple
inflammatory breast ca
describe skin changes associated with br ca
Asymmetric redness, discoloration, ulceration, skin retraction (dimpling if Cooper’s ligament involvement), changes in breast size & contour, nipple inversion, skin thickening
what is paget’s dz of nipple?
Chronic eczematous itchy, scaling rash on nipples & areola (may ooze) →
Lump is often present
describe inflammatory br ca
Red, swollen, warm, itchy breast → Often with nipple retraction, peau d’orange → Usually NOT associated with a lump
what is peau d/orange
Skin changes that look like the peel of an orange due to lymphatic obstruction → Associated with poor prognosis
dx of br ca
mammogram, US, bx
what may be seen on mammogram of breast ca?
Microcalcifications & spiculated masses highly suspicious for malignancy
what is the recommended initial modality to evaluate breast masses in women< 40 yo
US
types of biopsies used to evaluate breast mass
Fine needle with biopsy, large needle core biopsy, open/excisional biopsy
br ca staging:
Based on T (size), N (nodes → axillary lymph nodes), M (metastasis)
stage 0
Precancerous, DCIS or LCIS
stage 1-111
Within breast/regional lymph nodes
