L23: Breast Cancer Flashcards

1
Q

What are the risk factors for breast cancer

A
Age 
Geographic location 
Oestrogen exposure 
Family history 
Previous breast cancer- in the other breast 
Exogenous hormones- OCP and HRT used Long term 
High MI 
Ionising radiation 
Breast density- more glandular tissue 
ADH (atypical ductal hyperplasia)
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2
Q

What is ADH (atypical ductal hyperplasia)

A

When you have cells that change i.e atypical in the breast but are not cancerous

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3
Q

What is the nhs breast screening programme for

A

47-73 year olds

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4
Q

What does NHS Breast screening programmes involve

A

Digital mammogram that is done every 3 years

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5
Q

What does obesity lead to within the hormonal Profile

A

Activation of IGF1 and insulin
Increased oestrogen from adipose tissue
Increased leptin which interferes with oestrogen metabolism

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6
Q

If alcohol is excess how does it increase the risk of breast cancer

A
  • effects actaldeyhde which reduces oestrogen metabolism

- cause epigenetics changes via dna methylation

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7
Q

What type of cancer is BRCA1 mostly associated with

A

Basal like subtype

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8
Q

What is BRCA2 gene most likely associated with

A

Luminal (ER+) breast cancers

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9
Q

What are the 2 broad histological groups of breast cancers

A

In-situ

Invasive

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10
Q

What are the in-situ types of breast cancer

A

Ductal carcinoma in-situ

Lobular carcinoma in-situ

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11
Q

What are the invasive types of breast cancer

A

Ductal no special type
Lobular
Tubular
Mucinous

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12
Q

What is the difference between in-situ and invasive breast cancer

A

In-situ is confounded to the cells and does not breach the basement membrane
Invasive: breaches basement membrane to metastasis

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13
Q

What are the cells in in-situ breast cancer like

A

More mitosis i.e proliferated but basement membrane is fine

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14
Q

What are the cells like in invasive breast cancer

A

Basement membrane is breached so the Cells are migrating

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15
Q

What are the molecular subtypes of breast cancer

A
Basal like 
Luminal a 
Luminal b 
HER2 over expressing 
Claudin low 
Normal like
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16
Q

How do we find out the molecular subtypes of the breast cancer

A

When you disect the breast cancer you look for certain markers of oestrogen receptor, progesteorne receptors, HER2

17
Q

What is basal like breast cancer

A
BRCA1 positive 
Triple negative (ER,PR,HER2)
18
Q

What is luminal A

A

ER+

HER2-

19
Q

What is luminal b

A

Er+

HER2+

20
Q

What does the diagnosis of breast cancer involve

A

Triple assessment

  • clinical history and examination
  • mammograms or MRI
  • biopsy: FNA or core biopsy
21
Q

What are the treatment options for neo-adjuvant therapy

A

Endocrine e.g aromatase inhibitor
Chemotherapy (anthracycline surgery and taxanes
Herceptin, pertuzumab, lapatinib

22
Q

What are the surgery treatment options

A

Wide local excision
Mastectomy- breast removal or skin sparing for implant
Remove axillary lymph nodes

23
Q

What are the adjuvant therapy treatment options

A

Endocrine
Chemotherapy
Radiotherapy
Biological agents

24
Q

How can HER2 be targeted

A

Herceptin

Pertzumab

25
Q

What are the tyrosine kinase inhibitors we can use to inhibit the intracellular pathway

A

Lapatinib