Breast Cancer Flashcards
(43 cards)
What is the 10 year survival for Breast cancer?
80%
Describe the National Breast Cancer Screening
50-71 year olds are invited to screening every 3 years. There is currently a trial to examine effectiveness of extending age bracket. Those at moderate risk may be screened from 40 years old. If 71 or over, patients can self-refer. Screening is via a mammogram.
What are the risk factor for Breast cancer?
Age
Personal and family history (breast, ovarian)
Alcohol
Oestrogen exposure: early menarche, late menopause, late pregnancy, no or few children, contraceptive pill, HRT
Obesity
What genes are associated with breast cancer?
BRCA 1 and 2
CHEK 2
TP53
Where does breast cancer metastasise?
Bone Lung Liver Brain Adrenal Ovary
How might a patient with breast cancer present?
Nipple retraction Nipple discharge Crusting of areola Redness or pitting of skin Lump or thickening in breast or underarm that is painless Change in size of contours of breast
What is the NICE criteria for referral for Breast cancer via the suspected cancer pathway referral (two week wait)?
Women aged 30 and over with unexplained breast lump
Women aged 50 and over with symptoms in one nipple
What investigation is more sensitive if a patient is less than 35 years old?
USS of Breast (or MRI)
What are the two most common histological types of invasive breast cancer?
Invasive ductal carcinoma (80%)
Invasive lobular carcinoma (10%)
What is meant by “in-situ” carcinoma?
Cancerous cells in normal tissue do not breach the basement membrane
Which receptors guide choice of hormonal treatment?
HER-2
ER
PR
What imaging modality is more commonly used for young women and why?
USS. Young women have denser breast tissue (lots of glandular and connective tissue) and less fatty tissue.
What cause of a breast lump is commonest in younger patients?
Fibroadenoma
What age group do fibrocystic changes most commonly affect?
Ages 30-40
What non-malignant cause of a breast lump would you consider in a women aged 50 plus?
Cyst
What the life time risk for breast cancer?
1 in 8
What proportion of women who are sent for further assessment following a mammogram are diagnosed with breast cancer?
25% (1 in 4)
If someone stops their HRT, how long does it take for their risk of breast cancer to return to normal?
Straight away
If a women stops taking the contraceptive pill, how long does it take for their risk of breast cancer to return to normal?
Decreases once they stop taking the pill and risk is back to normal 10 years after stopping.
What are the types of biopsy that might be performed?
FNA for cytology - quick, lower morbidity, less uncomfortable
Core needle biopsy (most common) for histology - requires LA, takes longer, can determine receptor status and grade of tumour
Vacuum assisted core biopsy - takes multiple cores out of the tissue
Excisional biopsy - requires GA
What is the most common type of breast cancer?
Invasive ductal carcinoma (80%)
Invasive lobular carcinoma (10%)
What is meant by ‘in situ’ carcinoma?
Cancers cells in normal tissue do not breach the basement membrane
Outline the staging of breast cancer
TI: <2cm
TII: 2-5 cm and/or lymph nodes in armpit are affected
TIII: 2-5cm and May be attached to structures in the breast
TIV: tumour of any size and cancer has spread to other parts of the body
What is meant by the ‘grade’ of cancer?
Appearance of the cancer cells.
E.g. high grade (G3) - cells look very abnormal and are more likely to grow quickly
