GYN/ONC - Breast Cancer - collins Flashcards
(40 cards)
what are possible risk factors for breast cancer
mostly related to increased lifetime exposure to estrogen
early menarche (prior to age 12)
late menopause (after age 55)
older age at first pregnancy (>30) or nulliparity
OCP use
etc.
what are protective factors for breast cancer
lack of ovaries
no prior HRT
early menopause
longer duration of breastfeeding
earlier age at 1st pregnancy
low dose ASA
what is the primary location of breast cancer
upper outer quadrant
what are the histologic types of breast cancer
- noninvasive types: ductal and lobar carcinoma in situ
- invasive types: infiltrating ductal carcinoma, invasive lobular
- paget carcinoma
- inflammatory carcinoma
What is HER2
Human epidermal growth factor receptor 2
what can significantly impact the treatment course and prognosis of BCA
hormone responsiveness
What are the hormone responsiveness receptors
HER2/neu (+ or -)
Estrogen receptor (+ or -)
progesterone receptors (+ or -)
what tumors are more indolent, better progrnosis
ER/PR Positive tumors
What are BRCA mutations associated with
higher likelihood of developing breast cancer
what is a P53 mutation
tumor suppressor gene mutation
what are the indications for BRCA screening
breast cancer in 2+ first degree ralatives
+fh of BCA dx prior to age 50
+fh of ovarian CA
+fh of male breast CA
fist degree relative with bilat BCA
ashkenazi jew ancestery
what are typical symptoms of BCA
70% present with palpable lump - usu. painless, firm/hard, poorly defined margins
pain, asymmetry, nipple discharge, erosion, retraction, itching/enlargement of nipple, Peau d’orange
what are symptoms of Paget carcinoma
starts as nipple itching/burning; superficial erosions/ulceration
often misdiagnosed as bacterial infection/dermatitis
often no discrete breast mass
what are symtpoms of inflammatory carcinoma
rapidly growing, occasionally painful mass
breast enlargement
often misdiagnosed as infection
often no discrete breast mass
what is the gold standard screening test for breast cancer
mammography
what is BIRADs score
Breast imaging reporting and data system: mammography results
when are calcifications more likely to be malignant
<0.5mm, various sizes and shapres and clustered in one area
what are clustered calcifications in the breast called
clustered pleomorphic microcalcifications
who is recommended to get mammogram
women ages 40-74 years old get screened every 2 years
women age 40-49- shared decision making
who gets MRI for BCA workup
negative mammogram but still suspicious
if we want more information on a new BCA dx
breast implants
adjunct to mammogram if high risk
what is a BIRAD score of 0
inconclusive tests, needs further imaging
what is a BIRAD score of 2
known benign lesion
what is a BIRAD score of 5
highly suggestive of malignancy
mgmt: tissue diagnosis
what is BIRAD score of 6
known biopsy proven malignancy
mgmt: sx excision when clinical appropriate
