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68 Cards in this Set
- Front
- Back
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lifetime risk of developing breast cancer is ______% |
13 |
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lifetime risk of dying of breast cancer is _________% |
3.3 |
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risk factors |
age genetic prior history early menarche late menopause older age of pregnancy no pregnancies postmenopausal estrogen oral contraceptives alcohol diet |
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genetics: increase incidence in people with (5) |
Li-Fraumeni Syndrome Cowden's disease breast cancer-ovarian cancer syndrome BRCA1 and 2 HER2/neu oncogene |
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what is BRCA1 and BRCA2 |
a tumor supressor gene |
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BRCA 1 and BRCA 2 is mutated in how many percent of familial breast cancers |
50% |
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what is the lifetime risk of breast or ovarian cancer with people with BRCA1 or 2 mutation |
50-85% |
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increase risk of what with people with BRCA2 |
male breast cancer |
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symptoms of breast cancer |
painless bump or lump bloody discharge - usually benign papilloma crusting, scaling - paget's disease nipple retraction edema erythema contour changes adenopathy peau d'orange |
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neoplasms double every _________ days -minimal size for palpation -how many years to achieve palpable mass |
100 days 1cm 10 years |
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screening how often |
self exam monthly beginning at 20 clinical breast exam every 3 years at 20 mammogram starting at 40 annually |
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mammography detection: percent it does not detect cancer |
15% |
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routine mammogram screening can reduce mortality by ______% |
30 |
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how to biopsy the mass |
FNA core needle biopsy biopsy under local anesthesia - wire needle localization bilateral mammography prior to biopsy HER2/neu and ER/PR evaluation |
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two types of benign lesions |
fibroadenoma fibrocystic changes |
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fibroadenoma - how does it present |
painless, firm, mobile. solitary |
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fibroadenoma - what age group is it seen in |
young females |
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which is the most common type of benign breast tumor |
fibroadenoma |
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where does fibroadenoma arise |
terminal ductal lobular unit |
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fibroadenoma: macroscopic presentation |
firm, well circumscribed white yellow mass |
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fibroadenoma: histology |
epthelial and stromal components |
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treatment for fibroadenoma |
watch and wait vs excision vs cryoablation |
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fibrocystic changes affects ____ % of women |
50 |
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how does fibrocystic changes look like |
lump or bump most commonly in the UOQ |
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fibrocystic changes responds to... |
hormones -growth, pain |
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treatment for fibrocystic changes |
possibly anti-hormone |
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fibrocystic changes slightly increases... |
risk factor for breast cancer...2 folds |
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two types of in situ lesions |
ductal carcinoma in situ lobular carcinoma in situ |
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3 types of invasive cancers |
ductal carcinoma lobular carcinoma paget's disease of the breast |
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DCIS presentation |
may form a mass focal or multifocal |
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how is DCIS diagnosed |
microcalcifications on mammogram |
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the three grades of DCIS |
low, intermediate, and high |
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DCIS can not |
predict likelihood of invasive carcinoma |
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what tx is not preferred for DCIS |
mastectomy is overtreatment |
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LCIS characteristics (3) |
non-palpable not seen with a mammography may be diffuse thoughout both breasts |
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LCIS ____ risk of invasion bilaterally |
10-15% |
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which breast tumor is a risk factor for breast cancer |
LCIS |
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tx for LCIS |
close follow-up following removal or bilateral mastectomy |
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incidence of invasive ductal carcinoma |
80% |
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incidence of invasive lobular carcinoma |
10% |
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incidence of other types of invasive breast cancers |
10% |
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histologic variants of invasive breast cancers |
tubular medullary papillary mucinous |
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paget's disease is a form of ____________ |
in situ carcinoma -associated with underlying DCIS or invasive disease |
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paget's disease extends from |
nipple ducts to surrounding skin of nipple and areola |
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paget's disease clinically looks like |
crusting ulceration oozing |
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paget's disease - ___% of the time, what will hapen |
50% of the time, there is an underlying palpable mass represents underlying carcinoma |
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what are phyllodes tumors composed of |
epithelial and stromal elements |
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are phyllodes benign or malignant |
either |
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phyllodes tumors: characteristics |
bulky rarely metastasize do not spread to lymph nodes |
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phyllodes tumors how do we treat them |
wide excision or simple mastectomy |
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screening for metastatic disease |
bone scan for stage 3 or 4 chest x ray liver function test alkaline phosphatase - calcium and phosphorus |
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what is the most prognostic factor |
lymph node status |
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how to check lymph node status |
intraop sentinel lymph node evaluation |
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which lymph node involvement is most important |
axillary nodes |
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prognosis is based on |
size
lymph node mets grade stage |
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where do distant mets usually occur and the survival rate |
lungs, bone, liver, adrenal, cns 2-3 years |
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ER/PR when would they have a better response and what is used |
ER positive tamoxifen |
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HER2/Neu overexpression |
hgiher risk of recurrence and death |
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what is used for patients with HER2/neu overexpression |
Traztuzumab (Hercpetin) |
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types of surgical therapy for invasive cancers |
total mastectomy conservative resection of tumor with radiation therapy |
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what can happen with lymph node resection |
stewart-treves syndrome -lymphedema associated angiosarcoma |
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type of chemotherapy used for tx of breast ca |
herceptin tamoxifen |
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what are the risks after radiation therapy to the breast |
post irradiation angiosarcoma |
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adjuvant therapy can |
delay recurrence and prolong survival |
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______% decrease in ____________ with adjuvant chemo in what age women |
27% decrease in 10 year mortality with adjuvant chemo in women under 50 |
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adjuvant tamoxifen decreases annual rate of death by |
15% |
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how long should receptor positive breast cancer receive tamodifen |
5 years |
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four types of rehabilitation for breast cancer patients |
psychological sexual cosmetic physical |
