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Haematology & Oncology > Breast Cancer > Flashcards

Flashcards in Breast Cancer Deck (17)
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1
Q

What are the 3 genes most associated with familial cases of breast cancer?

A

BRCA1, BRCA2 and TP53 gene mutations

2
Q

What are the cancers associated with mutations to BRCA2 gene?

A

Breast cancer, Ovarian cancer, pancreatic, bowel, and endometrial cancer

3
Q

What is the condition caused by TP53 gene mutation? What cancers are seen in this condition?

A

Li-Fraumeni syndrome.

Breast cancer, Lung cancer, colon cancer, leukemia, adrenocortical, glioma, sarcoma.

4
Q

What are the characteristics of BRCA-associated breast cancer?

A

Younger age of onset

Frequently bilateral breast affected

Worse hislogical features: more aneuploidy, higher proliferation indices, higher grade, higher proportion with negative hormone receptor.

5
Q

Where does breast cancer often metastasise to?

A

Bone (70%), Lung (60%), Liver (55%)

6
Q

Nipple retraction is more likely in which carcinoma type: Ductal carcinoma or Lobular carcinoma?

A

Ductal carcinoma

7
Q

Which cancer is the most likely cancer to metastasise to the bone?

A

Breast cancer, followed by lung and prostate cancer

8
Q

The progression of metastasis through the lymph node in breast cancer is orderly/non-orderly.

A

Orderly

9
Q

Which imaging is for staging purposes in breast cancer?

What further imaging is done for suspicious findings?

A

CXR, US, bone scan.

CT, MRI or PET are further done for “suspicious findings”

10
Q

Are tumour markers used for staging in breast cancer?

A

NO.

11
Q

CT and MRI is used for what in breast cancer?

A

If there is clinical suspicion of metastasis.

12
Q

What are the indications for radiotherapy in those who have undergone mastectomy?

A

All tumours >5cm
Tumours deep in the breast, where surgical clearance is 3mm or less.
All patients with 4 or more lymph node metastases.

13
Q

Treatment for early breast cancer

A

Wide local excision and axillary node surgery, followed by breast radiotherapy (adjuvant)

14
Q

What is the management of metastatic disease?

A

Metastatic disease management includes radiotherapy to palliate painful bone metastases, and second-line endocrine therapy with aromatase inhibitors, which inhibits peripheral oestrogen production in adrenal and adipose tissue

15
Q

Give examples of adjuvant hormonal therapy. Who are they suitable for?

A

Tamoxifen and aromatase inhibitors for ER+ patients

16
Q

Who should be offered adjuvant chemotherapy?

A

Patients at higher risk of recurrence:

  • tumours >1cm
  • tumours that is ER(-)
  • presence of involved axillary lymph nodes

Normally, adjuvant radiotherapy is given

17
Q

What is the difference between core biopsy and FNA?

A

Core biopsy provides histology, whereas FNA only provides cytology.
Histological sample can detect breast cancer more accurately.