Breast Cancer &genetics

Question 1

most common form of cancer in american women?

Answer 1

breast

Question 2

breast cancer: Mortality rate has decreased for 1st time in several years, except in __________ _________women where it has increased.

Answer 2

African American

Question 3

leading cause of death for women age 20-59?

Answer 3

breast cancer

Question 4

over ___% of breast lumps are benign

Answer 4

80%

Question 5

fewer than ___ of women follow guidlines for breast cancer screening

Answer 5

1/3

Question 6

2 biggest risk factors for breast cancer

Answer 6

female, older

Question 7

who recommends against routine screening mammography in women ages 40 to 49 years? and replacing annual with biennial (every 2 years) screening mammography for women aged 50 to 74 years?

Answer 7

USPTF

Question 8

ACS screening guideline: asymptomatic age 20-39

Answer 8

breast Self examination: every month

clinical breast examination: every 3 years

Question 9

ACS screening guideline: asymptomatic age 35-40

Answer 9

Obtain baseline screening mammogram

Question 10

ACS screening guideline: asymptomatic age 40+

Answer 10

breast self exam: every month
clinical breast exam: annual
mammogram: annual

Question 11

4 signs of breast cancer

Answer 11

1. lump or thickening (breast or axilla)
2. change in size or shape of the breast
3. Discharge from the nipple (unilateral)
4. A change in the color or feel of the skin of the breast, areola, or nipple (dimpled, puckered or dry and scaly)

Question 12

4 types of imaging for breast cancer

Answer 12

Mammography
Ultrasound
MRI
Large Format Pathology

Question 13

do you need a physician referral for a mammogram?

Answer 13

NO not if its been a year since the last one

Question 14

does medicare and medicaid cover annual mammograms?

Answer 14

yes

Question 15

women with existing breast problems (abnormal screen, lump, nipple discharge, etc), will they get a mammogram screening?

Answer 15

NO this would be a Dx workup

Question 16

do you need a physician referral for a Dx workup?

Answer 16

YES

Question 17

for a Dx mammogram/US what must be done?

Answer 17

area of interest/abnormality must be described and located in “clockface” description and given to radiologist so they know where to focus on.

Question 18

pathology slide of biopsy: red vs blue/black? which is good and which is bad?

Answer 18

red- good

blue/black- bad

Question 19

an US guided core biopsy is only used if…

Answer 19

Used only if lesion is visualized by ultrasound

-lidocaine administered and tissue samples obtained easily

Question 20

what is the standard of care for invasive cancer?

Answer 20

sentinel lymph node biopsy

Question 21

what is a concern post- sentinel lymph node biopsy?

Answer 21

lymphedema

Question 22

5 txt options for breast cancer

Answer 22

1. Surgery
2. Chemotherapy – Oncotype DX
3. Radiation Therapy
4. SERMS/Aromatase Inhibitors
5. Targeted Therapy (Biotherapy)

Question 23

what is oncotype Dx? (maybe weeds)

Answer 23

biopsy and can tell if pt will respond to chemo before starting it

Question 24

what are the benefits of target therapy for cancer (biotherapy)?

Answer 24

recognizes cancer cells (chemo doesnt) - can give them for as long as they work. (chemo has a limited time for how long you can give it)

Question 25

what is large format pathology?

Answer 25

whole mastectomy or lumpectomy specimen is on a slide (can see the TRUE circumference of what you took out, wether margins are clear).

Question 26

what will be done after any mastectomy/lumpectomy?

Answer 26

MRI to be sure enough tissue was taken out

Question 27

has the re-excision rate increased or decreased over the last few years?

Answer 27

decreased

Question 28

BRCA1 and BRCA2 mutations are usually present only in ________ cancers. what type of genes are BRCA 1 and BRCA2?

Answer 28

hereditary

- BRCA1 and BRCA 2 are tumor suppressor genes (repaired damaged DNA prior to cell division). mutations in them = cancer

Question 29

BRCA mutations increase the risk of ____ ______ breast cancer, _____ cancer, and a ______ cancer

Answer 29

early onset breast cancer & ovarian cancer

increase the risk of a second cancer

Question 30

Increased risk of ovarian cancer following breast cancer
__-fold increase in risk compared to women without mutations
lifetime risk is at least ___%

Answer 30

Increased risk of ovarian cancer following breast cancer
10-fold increase in risk compared to women without mutations
lifetime risk is at least 16%

Question 31

what cancers (other than breast and ovarian) do BRCA genes increase the risk of?

Answer 31

male breast, prostate, pancreatic

Question 32

how many women with hereditary risk inherited it from their father?

Answer 32

half of all women

Question 33

___ ___ _____of breast cancer is more important than the number of women (in your family) with the disease.

Answer 33

age of onset

Question 34

prophylactic mastectomy for those with BRCA. is total (simple) or subcutaneous more effective? both of these.. do they remove all the breast tissue?

Answer 34

total (simple)

- removes most but not ALL of the breast tissue

Question 35

what is the “gold standard” of mutation detection? (for hereditary risk)

Answer 35

gene sequencing