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Yr 3 - Reproduction > Treatment of Breast Disease > Flashcards

Treatment of Breast Disease Flashcards

(55 cards)

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1
Q

How common is breast cancer?

A

1 in 8 women

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2
Q

What are the risk factors for breast cancer?

A 
Age
PMH
BRCA 1 + 2 
Early menarche and late menopause
Late or no pregnancy
HRT
Alcohol (>14units/week)
Weight
Post-radiotherapy (Hodgkins's disease)
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3
Q

How does breast cancer present?

A 
Asymptomatic
Lump
Breast pain
Nipple discharge (bloody)
Nipple changes 
Change in size/shape
Lymphoedema
Dimpling of breast skin
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4
Q

What nipple changes are seen in breast cancer?

A

Dryness - Paget’s disease

Retraction

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5
Q

What lymphoedema is suggestive of breast cancer?

A

Swelling of the arm

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6
Q

What radiological exams are used for breast cancer?

A

Bilateral mammograms/USS

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7
Q

What cytological exams are used for breast cancer?

A

FNAC

Core biopsy

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8
Q

Which is the most sensitive form of breast imaging?

A

Mammography

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9
Q

Breast imaging sensitivity is reduced in which women?

A

Young women (increased glandular tissue)

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10
Q

What is the most sensitive test for breast lumps?

A

FNAC

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11
Q

What are the different types of breast cancer?

A

Invasive

Non-invasive

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12
Q

What are the different types of invasive breast cancer?

A

80% Ductal carcinoma
10% lobular carcinoma
10% others

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13
Q

What are the other types of invasive breast cancer?

A 
Mucinous
Tubular
Papillary
Medullary
Sarcoma
Lymphoma
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14
Q

What are the types of non-invasive breast cancer?

A

Ductal Carcinoma In situ

Lobular carcinoma in situ

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15
Q

How is breast cancer staged?

A

FBC, U+E, LFT, CA2+/PO2-

Chest x-ray

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16
Q

What do abnormal LFTs suggest in breast cancer?

A

Advanced disease

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17
Q

How would a palpable tumour <2cm be staged?

A

T1

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18
Q

How would a palpable tumour 2-5cm be staged?

A

T2

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19
Q

How would a palpable tumour >5cm be staged?

A

T3

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20
Q

How would a tumour invading skin be staged?

A

T4a

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21
Q

How would a tumour invading chest wall be staged?

A

T4b

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22
Q

How would a tumour invading skin and chest wall be staged?

A

T4c

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23
Q

How is inflammatory breast cancer staged?

24
Q

How are breast tumours N-staged?

Study These Flashcards
A

N0 - No regional nodes palpable
N1 - Regional nodes palpable (mobile)
N2 - Regional nodes palpable (fixed)

25
How is breast cancer managed?
SURGERY Radiotherapy Chemotherapy Hormonal Therapy
26
What surgeries are given for breast tumours?
Breast conservation surgery | Mastectomy
27
What is the treatment for tumours <4cm?
Breast conservation + radiotherapy
28
What factors are taken into consideration for patients with breast tumours?
Breast/tumour size ratio | Patient's wishes
29
What is the use of axilla surgery in breast cancer?
Prognostic information/staging | Regional control of disease
30
When are sentinel lymph node biopsies performed?
When preoperative axillary USS are normal/benign
31
What treatment is required if the SLN biopsy is negative?
None
32
What treatment is required if the SLN biopsy is positive?
Surgical clearance | Radiotherapy to the axillary nodes
33
What complications are associated with axillary treatment?
``` Lymphoedema Sensory disturbance Decreased shoulder ROM Nerve damage Vascular damage Radiation-induced sarcoma ```
34
Sensory disturbance due to axillary treatment is associated with injury to which nerve?
Intercostobrachial nn.
35
Nerve damage due to axillary treatment is associated with injury to which nerve?
Long thoracic Thoracodorsal Brachial plexus
36
What factors are associated with increased risk of breast cancer recurrence?
``` Lymph node involvement Tumour grade Tumour size Steroid receptor status HER2 status (+ve) Lymphovascular invasion ```
37
What is the local adjuvant therapy for breast cancer?
Radiotherapy
38
What is the systemic adjuvant therapy for breast cancer?
Hormone therapy Chemotherapy Targeted therapy
39
Which breast cancer patients receive radiotherapy?
All patients after wide local excision (adjuvant) | After mastectomy if local involvement
40
What complications are associated with adjuvant breast radiotherapy?
``` Skin reactions - telangiectasis Radiation pneumonitis Cutaneous radionecrosis Osteonecrosis Angiosarcoma ```
41
What drugs are used in hormone therapy for breast cancer?
Tamoxifen Aromatase Inhibitors (Arimidex, Letrozole)
42
Which types of breast cancer hormone therapy be used for?
Estrogen receptor positive (ER+) breast cancer
43
Which dose of Tamoxifen is used for breast cancer hormone therapy?
20mg daily | 5-10 years
44
How does Tamoxifen work?
Directly blocks ER receptor
45
Tamoxifen is most effective in which groups?
All age groups | Post chemotherapy
46
Tamoxifen increases the risk of what?
Thromboembolic events
47
What Aromatase Inhibitors are used for breast cancer? (and what dose)
Arimidex (1mg) Letrozole (2.5mg) Both once daily 5 years
48
Aromatase Inhibitors are indicated in which breast cancer patients?
Estrogen Receptor Positive | POSTmenopausal women
49
Aromatase inhibitors increase the risk of what?
Osteoporosis
50
What is the role of Zoladex?
Hormone therapy for breast cancer | Inhibits FSH + LH
51
Which women benefit most from chemotherapy?
<50y/o | Patients with more adverse prognostic factors
52
What scoring is used to determine whether chemotherapy would be of benefit in breast cancer?
Oncotype DX
53
Which Chemotherapy drugs are used in breast cancer?
CMF Antracycline Taxane
54
Which drugs can be used in women with HER2+ breast cancer?
Anti-Her2 therapy | Trastuzumab (Herceptin)
55
What is the follow-up regiment post breast cancer treatment?
Patient observation Clinical examination 1-5 years Yearly mammograms

Yr 3 - Reproduction (37 decks)

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