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22 Cards in this Set
- Front
- Back
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Most common cancer in Australian females? |
breast |
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Impact of screening for breast cancer on mortality? |
20% reduction in mortality in those who have been screened |
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Breast cancer screening of asymptomatic women starts at what age? |
50 |
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True / false 1. All women regarded as high risk are eligible for referral to a familial cancer center for further assessment and advice 2. Having a family member with established presence of a high-risk breast cancer germline mutation places a patient as high risk for breast cancer 3. Having two first degree relatives with a history of breast cancer makes a female high risk |
1. True 2. True 3. False - needs to specify same side of the family AND needs another factor such as - additional family member with breast or ovarian Ca, Dx bilateral Ca, Dx male Breast Ca, Breast + ovarian in the same woman, Breast ca < 50 yrs or Ashkenazi jewish ancestry |
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Risk factors for breast cancer ?
As per risk calculator |
Two or more first- or second-degree relatives affected by breast or ovariancancer Young age at cancer diagnosis in relatives Relatives affected by both breast and ovarian cancer Relatives with a known germline mutation, for example, BRCA1, BRCA2 Relatives affected with bilateral breast cancer Male relative with breast cancer Ashkenazi Jewish ancestry
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First line investigation for female with a breast lump who is pregnant? |
USS |
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First line investigation for female with a breast lump who is > 35 yrs ? Excluding pregnant or lactating |
3D Mammogram |
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First line investigation for female with a breast lump who is < 35 ? |
USS |
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3D breast mammography may be of benefit in which populations? |
- Those with dense breast such as those < 50 yrs - Strong family history - Any breast symptoms /signs - Those with prior breast disease or requiring further assessment |
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Benefits of 3D mammography over 2D ? |
A 41% increase in invasive breastcancer detection • A 27% increase in all breast cancerdetection • A 15-40% reduction in recallrates • Potential to reduce the number ofavoidable biopsies • Ability to better visualise masses,distortions and asymmetric densities • Increased detection in women withdense breasts — that is, predominantlyfibroglandular tissue, as iscommon in women under 50 |
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What type of mammography is used in standard screening ? |
2D mammography Evidence based - for population screening |
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Medicare covers mammography for who? |
2D or 3D For those with a suspected malignancy due to - Past breast Ca - Family history - Symptoms or signs suggestive |
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Which of the following are are T/F? 1. Sensitivity of mammography decreases with increasing age. 2. Addition of USS to mammography increases sensitivity in all age groups. 3. USS is first line for those < 35, pregnant of breast feeding for assessment of the breast. |
1. False, decreases with decreasing age due to dense breast tissue of younger people 2. True but greater for < 50's 3. True |
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Benefits of Contrast-enhanced breast MRI? |
1. Very high sensitivity - 94% (compared with 40% mammography alone) 2. Specificity similar to USS and/or mammography ~98% 3. Increased proportion of node negative cancers detected vs mammography alone |
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Evidence for mortality benefit from MRI breast screening? |
No evidence for high risk patients but "Projected 25% benefit" An alternative to strategy to prophylactic bilateral mastectomy |
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Breast MRI screening is not covered by medicare. T/F |
False Covered for screening asymptomatic HIGH risk women under 50 after referral by a specialist |
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Breast lesion biopsy is preferred to be done under what visual guidance? |
Ultrasound - cheapest, fastest But if lesions can only be seen on mammography or MRI then this will need to be facilitated |
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When reporting breast imaging the report may contain a percentage of breast density. Why? |
Higher then 50% --> dense breasts This reflects the accuracy and the ability of the scan to detect a lesion, as it is harder in dense breasts vs fatty breasts |
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Germline mutations associated with breast cancer? |
BRCA1 BRCA2 TP53 PTEN PALB2 |
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Risk of breast cancer with BRCA1/2 ? |
BRCA 1 - 55% by 70 BRCA 2 - 47% by 70 In women |
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Is genetic testing covered by medicare? |
No But some state health departments will cover it if ordered by a genetic specialist |
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Who to refer for screening of breast cancer? |
Moderate to high risk Often refer these patients to local specialist to aid in breast cancer screening. In particular bilateral breast MRI for < 50 - free after specialist referral |
