ECR Breast Cancer Flashcards Preview

ECR 2012 > ECR Breast Cancer > Flashcards

Flashcards in ECR Breast Cancer Deck (31):
0

What are palapable masses of breat

Breast cancer occurs in up to 4% women with brst copleints, 5% women reproting nipple discharge, and up to 11% of women specifically complaining of a breast lump or mass

2

Common lesion in 15-25 year olds

Fibroadenoma

3

Characteristic of fibroadenoma

usually fine, round, mobile, nontender

4

Common lesions in 25-50 year old

Cysts- soft to firm, round, mobile, often tender

fibrocystic changes-nodular, ropelike

Cancer- irregular, stellate, firm, not clearly delineated from surrounding tissue

5

over 50 common lesion

cancer until proven otehrwise

6

Pregnancy/lactation

lactating adenomas, cysts, mastitits, cancer

7

what percent of cancers is breast cancer

10% in women

8

what is chace of women getting brast caner

12% or 1/8 chance in liefetime

9

what has lead to declines in new cases of invasive breast cancer

1. decreased mamography screening , which leads to underdiagnosis or delayed diagnosis rather than true decrease in disease incidnece

2. decreased use of hormone replacement therapy (HRT)

10

what are two trends in breast cancer

declines in new cases of invasive breast cancer

earlier and more advanced breast cancer in african american women

11

What is Gail model?

tool incorproates risk factors of age, first degree relatives with breast cancer, previosu breast biopsies and presence of hyperplasia, age at menarche, and age at first delivery. It assumes annual screenign and no pateinte history of breast cancer

12

Claus Model

for women with a family history of second degree maternal or paternal relatives with breast cancer

13

what risk factors are not included in teh Gail or Claus model?

breast density, plasma levels of free estradiol, bone desity, post-menopausal eight gain, or waist-to-hip ration

14

Factors that affect circulating hormoenes and have a 1.1-2.0 risk

late age at first full term preancy (>30 years)
Early menarhce (55)
No full-term pregnancies
Never breast-fed child
Recent oral contraceptive use
Recent and long-term use of HRT
Obesity (postmenopausal)

15

What is chances of women with BRCA1 mutations to develop breast cancer by age 70>

65%

16

What is percent of women that have BRCA2 mutations will develop breast cancer by age 70

45%

17

What is criteria for Identying women at risk for BRCA1 or 2 mutation?

using risk calculation
establish one of the following risk factors
-1st dgree relative with known BRCA1 or 2 mutaiton

->2 relatives with diagnosis of breast caner and >1 occured before age 50

->2 relatives with a diagnosis of ovarian cancer

->1 relative with a dignosis of breast cancer and >1 reltive has a diagnosis of ovarian cancer

18

Risk of breast cancer and hisotlogy of benigh breast lesions;

No increased risk
Small increased risk
Moderate increased risk

19

No increased risk; relative risk appox 1.3

nonproliferative changes: cysts and ductal ectasia, mild hyperplasia, simple fibroadenoma, mastitits, granuloma, diabetic mastopathy

20

Small increased risk, 1.5-2.0

Proliferative withotu atypia: usual ductal hyperplasia, complex fibroadenoma, papilloma

21

Moderate increased risk o>2 -4.2

Proliferative with atypia: including atypical ductal hyperplasia and atypical lobular hyplasia

22

what is the most undervalued and underused risk factor in ammmograms?

breast density. " present int he tusses from with cancer arises"

23

60-75% more radiologially dense, have how much greater risk of breast cancer?

4-6x greater risk than those with no brast density

24

use of mammography in women 40-50 years

false positives; mammography every 1-2 years; 15% reduction in breast cancer mortality after 14 years of follow up

25

Use of mammography in women 50 years or older

reduces breast cancer mortality by 15-35%

annually

26

Clinical Breast Examination

ACS recomments CBE every 3 years for 20-40 years and annually after 40 years old

27

BSE- breast self exam

monthy 5-7 days after onset of menses can b

28

MRI

helps detect multicentric or contralateral breast cancer prior to managmetn decisiona bout breast-conserving strategies

ACS recommneds brast MRI for women at high lifetime risk or risk of 20% or more

29

High Risk 20-25% (Refererals for Breast MRI)

known BRCA1 or 2 mutation
Known 1st degree rlative, including father, brother, with BRCA1 or 2 mutation, but woman not tested

lifetime risk 20-25% using assessment tools

Hx of chest radiation between agest 10-30

High risk genetic syndeome or first degree relative with high risk syndrome

30

Moderate risk 15-20% (Referrals for Breast MRI)

Extremely dense breases or unevenely dense breasets

Hx of breast canver, ductal o lobular carcinoma in situ, atypical ductal or lobular hyperplasia

31

Chemoprevention

estrogen-receptor modulator in women at high risk for breast cancer and at low risk for adverse effects