Term
| 62 yo woman presents with suspicious breast mass. Mammography reveals clusters of microcalcifications and stellate lesions. A biopsy confirms invasive cancer. What is the next step? |
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Definition
| Test for estrogen adn progesterone receptor status and HER2/neu status. |
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Term
| What are the risk factors for breast cancer? |
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Definition
Female
Older age
1st degree relative with breast cancer
Prior history of breast cancer
History of atypical ductal or lobular hyperpasia or carcinoma in situ.
Early menarche, late menopause, or late first full-term pregnancy (after age 35)
HRT use for >5 years
Obesity
Prior radiation therapy |
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Term
| What are symptoms of Breast Cancer? |
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Definition
Hard, irregular, immobile, painless breast lump, +/- discharge
Skin changes (dimpling, erythema, ulceration)
Axillary adenopathy (more advanced disease)
ANY BREAST MASS in postmenopausal women is breast cancer until proven otherwise. Most commonly in upper outer quadrant |
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Term
| What are the steps in diagnosis of Breast Cancer? |
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Definition
Mammographic abnormalities, confirmed by biopsy.
>35 yrs +lump, -mammogram; get US, FNA, core biopsy, or excisional biopsy until convinced no cancer.
<35 US; Be wary of proceeding too quickly in pts with no FHx.
Biopsied specimens tested for ER/PR and HER2 (estrogen and progesterone receptors) |
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Term
| What is inflammatory breast cancer? |
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Definition
| Highly aggressive, rapidly growing cancer that invades the lymphatics and causes skin inflammation. Poor prognosis |
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Term
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Definition
| Ductal caracinoma in situ (DICS) of the nipple with unilateral itching, burning, and nipple erosion. May be mistaken for infection; associated with focus of invasive carcinoma. |
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Term
| What is the treatment for DCIS? |
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Definition
| Local therapy only (mastectomy OR wide excision plus radiation therapy). |
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Term
| What is the treatment for LCIS? |
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Definition
| Associated with high risk of developing infiltrating breast cancer, including contralateral breast. Options include close monitoring, mastectomy, or tamoxifen for prophylaxis. |
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Term
| What is the treatment for Invasive breast cancer? |
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Definition
| Based on lymph node status, tumor size, and hormone receptor status. |
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Term
| Invasive breast cancer with node (-) dz: treatment? |
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Definition
| Stage I can be treated with breast conservation therapy (wide excision) or modified radical mastectomy with radiation. |
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Term
| Invasive breast cancer: Adjuvent treatment? |
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Definition
| Two or more agents (5-FU, methotrexate, doxorubicin, cyclophosphamide, or epirubicin for 3-6 months for tumors >2cm or those with axillary lymph node involvement (stage II -III) |
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Term
| Invasive breast cancer: Endocrine treatment? |
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Definition
tamoxifen, raloxifene, or armatase inhibitors (anastrozole) are beneficial only for patients with ER+ or PR+ tumors.
Herceptin (Trastuzumab) is beneficial for those with HER2-neu+ tumors. |
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