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20 Cards in this Set
- Front
- Back
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What are risk factors for developing breast cancer?
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70% of breast cancer patients do not have a recognizable risk factor. BRCA-1 and BRCA-2 are tumor suppressor genes; if either one is present, the risk is from 35-84%.
-Family history increases risk -Low age (~11) of menarche is a risk factor -The older the age of first child birth increases risk -Late menopause (after 55) increases risk -Long use of oral contraceptives before 1st pregnancy can increase risk -Postmenopausal estrogen replacement increases risk -Alcohol increases risk |
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What are local signs and symptoms of breast cancer?
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-painless, palpable lump is most common
-palpable lymphnodes may be present -malignant mass is typically solitary, unilateral, solid, hard, irregular, and nonmobile |
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What are signs and symptoms that breast cancer has metastasized?
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-bone pain
-difficulty breathing -abdominal pain -jaundice -altered mental status |
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What lab tests can be used to detect breast cancer?
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-tumor markers CA 27.29 or CEA may be elevated
-alkaline phosphatase or LFTs often are elevated in metastatic disease |
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What are the main imaging techniques for detecting breast cancer?
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1. Mammography
2. Ultrasound 3. MRI |
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When should breast self examination begin?
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Should start in 20s. Women should know how their breasts normally feel and report any breast change promptly to their healthcare provider.
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When should clinical breast examination begin?
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In 20s and 30s this should be part of a periodic health exam, at a minimum of every 3 years. At age 40 and older, it should be done every year.
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When should mammograms begin?
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In the 40s or 50s and should be given at least every other year.
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What are the stages of breast cancer?
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Tumor size (T1-T4)
Lymph node involvement (N1-N3) Distant metastases (M0-M1) |
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What does nodal involvement tell you about the prognosis of breast cancer?
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-ten year disease free survival for N0 patients is 70-80%
-ten year disease free survival for patients with lymph node involvement is 20-30% |
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How is estrogen/progesterone receptor status used in the prognosis of breast cancer?
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Tumors with concentrations of estrogen or progesterone receptors greater than 10 fmol/mg of tumor are considered ER+ or PR+. About 50-70% of patients are ER+. 50-60% of ER+ patients will respond to hormonal therapy. Only 5-10% of ER- will respond to hormonal therapy. 80-90% of ER+/PR+ will respond to hormonal therapy.
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How does HER-2 status affect breast cancer prognosis?
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HER-2 is a transmembrane tyrosine kinase growth factor receptor. It is usually expressed at low levels in breast tissue. Over expression is associated with transmission of growth signals that control aspects of normal cell division. HER-2 over expression occurs in 20-30% of BCAs and is associated with tumor aggressiveness, increased rates of recurrence, increased mortality, and poor prognosis.
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What is radical mastectomy?
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Complete removal of breast, axillary lymph nodes, and pectoral muscles. Complications include edema, loss of strength, and loss of movement.
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What is a modified radical mastectomy?
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Complete removal of breast and axillary lymph nodes. Standard procedure leaves muscles intact.
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What is a total mastectomy?
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Complete removal of breast. Does not always allow adequate sampling of the lymph nodes. Primary use is in carcinoma in situ.
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What is a partial mastectomy?
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Includes segmental mastectomy and lumpectomy, used in combination with axillary node resection and radiation.
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What are the main treatments of breast cancer?
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Surgery
Chemotherapy |
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What is neoadjuvant chemotherapy?
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The use of systemic chemotherapy prior to surgery. It decreases (debulks) the size of large tumors to allow for removal by lumpectomy.
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What is adjuvant chemotherapy?
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The use of systemic chemotherapy to treat undetected micrometastases following radiation or surgery. It is used because cancer has often spread beyond local disease at time of diagnosis.
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Describe hormal therapy used in breast cancer.
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It reduces rate of relapse in HR+ BCA. Initial therapy of metastatic BCA with HR+ tumors should consist of hormonal therapy. Women who respond to hormonal therapy once will usually have a good response a second time.
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