Breast Vivas Flashcards
Non modifiable RFs for breast cancer
Age
FH
Genetics: BRCA1/ BRCA2
Nulliparity/ not breastfeeding
Early menarche, late menopause
Ionising radiation
Past breast cancer
Modifiable RFs for breast cancer
HRT
COCP
Alcohol
Obesity
Most common breast cancer
Invasive ductal carcinoma
Screening for breast cancer
Every 3y from 50-70
Mammogram
Treatment of breast cancer
Wide local excision or mastectomy
+/- Whole breast radiotherapy
+/- Hormone therapy
+/- Biologic therapy
Prior to surgery, what should be performed in women with no palpable axillary lymphadenopathy at presentation?
Pre-op axillary US
If -ve: sentinel node biopsy to assess nodal burden
In women with palpable axillary lymphadenopathy at presentation what is indicated?
Axillary node clearance at primary surgery
Name 2 complications of axillary node clearance
Arm lymphedema
Functional arm impairment
5 indications for mastectomy
Multifocal tumour
Central tumour
Large lesion in small breast
DCIS >4cm
Patient choice
5 indications for wide local excision
Solitary lesion
Peripheral tumour
Small lesion in large breast
DCIS <4cm
Patient choice
What treatment can be used for oestrogen receptor positive breast cancer?
Pre- / perimenopausal: Tamoxifen
Post menopausal: Anastrazole (Aromatase inhibitor)
3 sides effects of Tamoxifen
Increased risk endometrial cancer
Increased risk VTE
Menopausal Sx
What biological therapy is used in breast cancer that HER2 positive?
Herceptin (Trastuzumab)
Name a contraindication to Trastuzumab
Hx of Heart disorders
What tool gives indication of survival in breast cancer?
Nottingham Prognostic Index
(Tumour size, LN score, grade score)
