Flashcards in Breast Cancer Deck (17)
What are the 3 genes most associated with familial cases of breast cancer?
BRCA1, BRCA2 and TP53 gene mutations
What are the cancers associated with mutations to BRCA2 gene?
Breast cancer, Ovarian cancer, pancreatic, bowel, and endometrial cancer
What is the condition caused by TP53 gene mutation? What cancers are seen in this condition?
Breast cancer, Lung cancer, colon cancer, leukemia, adrenocortical, glioma, sarcoma.
What are the characteristics of BRCA-associated breast cancer?
Younger age of onset
Frequently bilateral breast affected
Worse hislogical features: more aneuploidy, higher proliferation indices, higher grade, higher proportion with negative hormone receptor.
Where does breast cancer often metastasise to?
Bone (70%), Lung (60%), Liver (55%)
Nipple retraction is more likely in which carcinoma type: Ductal carcinoma or Lobular carcinoma?
Which cancer is the most likely cancer to metastasise to the bone?
Breast cancer, followed by lung and prostate cancer
The progression of metastasis through the lymph node in breast cancer is orderly/non-orderly.
Which imaging is for staging purposes in breast cancer?
What further imaging is done for suspicious findings?
CXR, US, bone scan.
CT, MRI or PET are further done for "suspicious findings"
Are tumour markers used for staging in breast cancer?
CT and MRI is used for what in breast cancer?
If there is clinical suspicion of metastasis.
What are the indications for radiotherapy in those who have undergone mastectomy?
All tumours >5cm
Tumours deep in the breast, where surgical clearance is 3mm or less.
All patients with 4 or more lymph node metastases.
Treatment for early breast cancer
Wide local excision and axillary node surgery, followed by breast radiotherapy (adjuvant)
What is the management of metastatic disease?
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
Give examples of adjuvant hormonal therapy. Who are they suitable for?
Tamoxifen and aromatase inhibitors for ER+ patients
Who should be offered adjuvant chemotherapy?
Patients at higher risk of recurrence:
- tumours >1cm
- tumours that is ER(-)
- presence of involved axillary lymph nodes
Normally, adjuvant radiotherapy is given