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Breast cancer
| Question | Answer |
|---|---|
| At what age is Br Ca more frequent | Over 25, Pm women. The incidence rises after 30. |
| What are Br Ca risk factors | Woman, age 70-80, fiRST degree relative with Br CA, early menarche, late menopause, Obesity, Nuliparity and hormone replacement therapy. Breast feeding is protective. The age of first birth: before 20 protects, after 35 is risk factor. |
| What is the screening tool for Br Ca | mamography |
| How can we classify Br Ca? | According to invasion of basal membrane: non invasive (Ductal in situ-DCIS) and lobular in situ (LCIS). Also paget disease is considered as non invasive. |
| What can differenciate DCIS from LCIS? | DCIS has microcalcifications |
| What can differenciate DCIS from paget? | Paget is like an extension of DCIS, there is dermal invasion and extendes t o the nipple |
| Patterns of DCIS | Central necrosis , precancerous esion, high risk of Ca |
| Caharacteristics of Paget | Erythema of the nipple due to UL malignancy, extension of DCIS into ducts, bloody discharge (differentiate from intraductal papilloma), Dx: Biopsy (halo in cells): paget cells. Its rare. Palpable mass in over 50%. |
| LCIS pattern | Discohesive growth, loss of E cadheine (lose of intercelular connections), NO MICROCALCIFICATIONS, Usually INCIDENTAL FINDING in Bx. Often bilateral |
| Is LCIS visible in mamogram? | NO! Only Bx, RF for invasive carcinoma |
| Treatment of LCIS | Surveillance plus Chemoprevention : Tamoxifen (SERM) --- similar to estrogen , block estorgen effects No sense on surgical because is mutilfocal , this is a ER AND PR POS TUMOR |
| Which is the most common type of Br Ca? | Invasive Ductal carcinoma |
| Bx and clinical characteristics of invasive ductal carcinoma | Duct of cells with stroma, cords of cells and nests . Firm, hard, stellar morphology. |
| Peau d`orange | Inflammatory carcinoma, invasion of sin, thourgh lymphocitic vessels , high grade, poor prognosis ( 3 year survival: 3%) |
| Small cells in single file with mamary stroma invasion | Invasive lobular carcinoma |
| How is the prognosis of Br CA defined? | Depending on axillary lymph node methastasis (bx of sentinel node) and HERR2 (+) |
| What are the marers for Br Ca | ER(+), PR (+), HERR2 (+) Precitive markers: - ER+ and PR +--------> Tamoxifen -HERR2 + ---------> Trastuzumab (monoconal Ab against HERR) - Triple negative tumor: very aggresive , less than 40 yo women |
| Percentage of genetic influence in Br Ca | 10%, AD, incomplete penetrance BRCA1 and BCRA 2 (both code for DNA repair proteins) |
| BRCA1 | Ovarian Ca |
| BRCA 2 | Male breast cancer, pancreatic cancer |
| Key associations of male breast cancer | Klinefelter sx (47XXY) 3-8% BRCA2 4-14% |
Created by:
marticaospina81
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