Term
| Which hormones do female breasts develop under during puberty? |
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Definition
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Term
| What changes occur to the breast post-menopause? |
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Definition
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Term
| Describe the structure of the breast. |
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Definition
15-20 glandular breast lobes.
Interlobular connective tissue.
Adipose tissue.
Nipple and areola. |
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Term
| Describe the histopathological features of atypical ductal hyperplasia (epithelium and cytology). |
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Definition
Epithelium would be more than 2 cell layers thick. Proliferating epithelium fills and distends ducts and lobules.
Atypical cytology - cellular enlargement and nuclear pleomorphism. |
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Term
| How many women in the UK will develop breast cancer? What percentage of all cancers in women does it account for? |
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Definition
1 in 9 women will develop the disease.
It accounts for 30% of all cancers in women. |
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Term
| Name the risk factors for breast cancer. |
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Definition
| Female sex, increasing age, long interval between menarche and menopause, older age at first full-term pregnancy, obesity and high-fat diet, previous breast cancer, atypical ductal hyperplasia in a previous breast biopsy, family history of breast cancer, geographic factors, previous irradiation. |
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Term
| Name the three main genes involved in breast cancer. |
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Definition
BRCA 1, BRCA 2 and p53 (Li-Fraumeni syndrome).
Others include Cowden syndrome, Ataxia Telangectasia, Peutz-Jeghers syndrome. |
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Term
| What is involved in the triple assessment? |
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Definition
| Clinical examination, radiology (mammography, ultrasound, MRI), pathology (Fine Needle Aspiration cytology, core biopsy, mammotome). |
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Term
| Name the clinical features of breast cancer. |
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Definition
Pain (mastalgia), palpable mass, nipple discharge / retraction, peau d'orange, skin puckering / tethering, erythema, axillary lymphadenopathy, metastatic symptoms (e.g. bone pain or fracture).
May be asymptomatic. |
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Term
| In non-invasive carcinomas, where are the malignant cells confined to? Is there any tumour cell penetration through the basement membrane? |
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Definition
Malignant cells are confined to ducts or lobule.
There is no tumour cell penetration through the basement membrane. |
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Term
| In invasive carcinomas, do malignant cells penetrate through the basement membrane? |
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Definition
| Yes - and they invade surrounding tissues. |
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Term
| What does the grade of a tumour measure? |
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Definition
| The degree of tumour cell differentiation. |
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Term
| What does the grade of a tumour depend upon? |
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Definition
| Tubule formation, nuclear pleomorphism, mitoses. |
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Term
| What does the stage of the tumour measure? |
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Definition
| The extent of tumour spread. |
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Term
| Staging is measured through TNM. What does TNM represent? |
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Definition
T - extent of primary tumour.
N - absence or presence and extent of regional lymph node metastasis.
M - absence or presence of distant metastasis. |
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Term
| Name the local and distant sites metastasis can spread to. |
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Definition
Local - skin and muscle.
Distant - regional lymph nodes, lung and pleura, liver, bone, adrenals, skin, brain. |
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Term
| What are the treatment options for invasive carcinomas? |
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Definition
| Surgery, radiotherapy, chemotherapy, hormone therapy. |
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Term
| What are the three receptors involved in tumour receptor staining? |
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Definition
| ERBB2 / HER-2, Oestrogen receptor (ER) and Progesterone receptor (PR). |
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Term
| Describe the role of HER-2 in invasive breast carcinomas. |
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Definition
Her-2 is altered in 20% of invasive breast carcinomas - it is over-amplifed and its membrane-related protein is over-expressed.
Herceptin can be used to treat women whose cancers have this molecular alteration. |
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Term
| Tamoxifen, aromatase inhibitors and hereceptin are treatment options for the positive detection of which receptors? |
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Definition
Tamoxifen and aromatose inhibitors = oestrogen receptor positive.
Hereceptin = HER2 positive. |
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Term
| Does triple-negative breast cancer respond well to chemotherapy? |
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Definition
| No - it is resistant to standard chemotherapy. There are no effective targeted therapies for this cancer. |
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Term
| BRCA-2 tumours are predominantly what type of tumours? |
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Definition
| High-grade invasive ductal carcinomas of no special type. They demonstrate a luminal pheontype despite their high histologic grade. |
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Term
| What two conditions affect the male breast? |
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Definition
| Gynaecomastia and carcinoma. |
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Term
| What are the risk factors for male breast carcinoma? |
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Definition
First degree relative affected, decreased testicular function, increasing age, infertility, obesity, prior benign breast disease, irradiation.
4-14% is due to germline BRAC2 mutations. |
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Term
| What is male breast carcinoma generally treated with? |
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Definition
| Mastectomy and axillary node dissection. Chemotherapy and radiotherapy may also be suitable. |
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