Investigations Flashcards
(32 cards)
Staging vs grade? (2)
- Staging: how much has it metastisied
- Grade: how much like a breast cell does it look? The more it does the better
Sentinal node biopsy reason and method (2)
Finding node to which the tumour will metastitise first
- Inject blue dye/radioactive isotope traced with gamma camera
What is the rule for cannulations in a patient with an axillary excision?
Do in the other arm as impaired drainage
Core needle biopsy method (3)
- Ultrasound guided
- Large needle guided into lump
- Small cylinders of tissue (cores) removed
What should anyone with a breast lump should be referred for?
Triple assessment
What does triple assessment consist of in breast? (3)
- Examination
- Radiology
- Histology/cystology
What radiology technique is best for women above 35 for breast? Why?
Mammogram - tissue not dense anymore so tumours show
What radiology technique is best for women under 35 for breast? Why?
Ultrasound - young breast tissue too dense to show tumours
Define stage 1 breast cancer
Confined to breast, mobile
Define stage 2 breast cancer
Confined to breast
Mobile
Lymph nodes in ipsilateral axilla
Define stage 3 breast cancer (3)
- Tumour fixed to muscle (but not chest wall)
- Ipsilateral lymph nodes matted/fixed
- Skin involvement more than tumour
Define stage 4 breast cancer
- Complete fixation of tumour to chest wall
- Distant metasteses
Define the T part of the TNM staging of breast cancer
- T1 = less than 2 cm
- T2= 2-5cm
- T3 = 5cm+
- T4=fixation of tumour to chest wall/peau d’orange
How often and what age of women are offered breast screening?
3 yearly 50-70 years
What does breast screening involve? (2)
2 mammogram views of breast taken - cranio caudal and lateral oblique
Define the NM part of the TNM staging of breast cancer
N1: mobile ipsilateral nodes
N2: fixed nodes
M1: distant metasteses
What do cells that look more undifferentiated have a higher grade (i.e worse prognosis)? (3)
- Loses differentiated characteristics
- Cellular machinery increases activity
- Higher mitotic index
Clear excision margin meaning?
No cancer cells are seen at the outer edge of the tissue that was removed
What type of breast cancer has a better prognosis?
Oestrogen positive
Indication for wide local excision vs mastectomy (2)
Multifocal? Fhx?
What is a triple negative cancer? Why does it have a worse prognosis?
Does not express genes for
- Oestrogen receptor (ER)
- Progesterone receptor (PR)
- HER 2
(drug therapy targets)
Hormone markers measured in breast tumours?
- Oestrogen
- Progesterone
- HER 2
Oncotype dx indication?
Likelihood of breast cancer returning test
Determines need for chemotherapy as added to hormone therapy
Oncotype scores meaning
Score 0-17: Low recurrence (chemotherapy risks ouweigh benefits)
- Score 18-30: medium recurrence score = uncertain
- Score 31-100: high recurrence score
(chemotherapy benefit worth risk)
