Term
| What percentage of breast masses are benign? |
|
Definition
|
|
Term
| What are the most common breast masses? |
|
Definition
|
|
Term
| What are the most uncommon breast masses? |
|
Definition
carcinoma
fat necrosis
galactocele
lipoma |
|
|
Term
| What causes of breast masses are usually bilateral? |
|
Definition
infiltrating lobular carcinoma
cysts |
|
|
Term
| What causes of breast masses are usually unilateral? |
|
Definition
fibroadenoma
DCIS
Paget's disease |
|
|
Term
| What type of tumor can either be benign or malignant? |
|
Definition
|
|
Term
| What is the most common type of dominant breast lump? |
|
Definition
|
|
Term
| What age group has the highest incidence of breast cysts? |
|
Definition
35-50 year olds
rare in postmenopausal women |
|
|
Term
| What components of the history are common in women with breast cysts? |
|
Definition
tender mass
assocaited with UOQ pain-->axilla
size and pain may increase with menses |
|
|
Term
| What physical exam findings are consistent with breast cysts? |
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Definition
| firm, well-circumscribed, freely mobile, fluid-filled sac |
|
|
Term
| How is a diagnosis of a breast cyst made? |
|
Definition
ultrasound/mammogram
FNA (ultrasound guided) |
|
|
Term
| What is the treatment for breast cysts? |
|
Definition
FNA
surgery if bloody, doesn't resolve, or recurs |
|
|
Term
| What is the most common form of benign breast mass? |
|
Definition
|
|
Term
| What components of the history are common in a pt. with a fibroadenoma? |
|
Definition
usually painless
may increase at end of menstrual cycle |
|
|
Term
| What physical exam findings are consistent with fibroadenomas? |
|
Definition
painless
solid, well-circumscribed, freely mobile
round, lobulated, or discoid
"rubbery" in texture or hard |
|
|
Term
| How is a diagnosis of fibroadenoma made? |
|
Definition
ultrasound/mammogram
excision/biopsy |
|
|
Term
| What is fat necrosis associated with? |
|
Definition
prior trauma
MVA, assault, surgery, radiation |
|
|
Term
| What is the most common cancer among American women next to skin cancers? |
|
Definition
|
|
Term
| What are the odds for a woman developing breast cancer at some point in her life? |
|
Definition
|
|
Term
| What percentage of women with breast cancer have a family history of breast cancer? |
|
Definition
|
|
Term
| What is the earliest, non-invasive form of breast cancer? |
|
Definition
|
|
Term
| What is the second leading cause of cancer death in women, exceeded only by lung cancer? |
|
Definition
|
|
Term
| The chance that breast cancer will be responsible for a woman's death is about 1 in ____. |
|
Definition
|
|
Term
| What percentage of new diagnoses of breast cancer have no risk factors? |
|
Definition
|
|
Term
| What risk factors are associated with breast cancer? |
|
Definition
-1st degree relative with breast CA
-genetics BRCA1/BRCA2 gene
-personal hx of breast CA
-whites > blacks (blacks have higher mortality rate due to late detection)
-prior bx with atypical hyperplasia
-age > 50
-menses < 12, menopause >50
-DES therapy
-nulliparity or 1st pregnancy > 30 yo
-OCP or HRT use
-EtOH, obesity |
|
|
Term
| What are the controversial risk factors associated with breast cancer? |
|
Definition
antiperspirant
underwire bras
smoking
induced abortion
breast implants
night work |
|
|
Term
| What physical exam findings are consistent with breast cancer? |
|
Definition
-palpable, hard, firm mass with diffuse margins often fixed to the chest wall
-may or may not have pain
-nipple retraction or discharge
-change in breast size or configuration
-lymphadenopathy |
|
|
Term
| What diagnostics are used for breast cancer diagnosis? |
|
Definition
comprehensive mammogram
FNA (only for cystic lesions)
core needle biopsy (for solid lesions)
mammotome
open/excisional bx
sentinel lymph node bx |
|
|
Term
| abnormal cells in the lining of a milk duct that haven't invaded the surrounding breast tissue |
|
Definition
| ductal carcinoma in situ (DCIS) |
|
|
Term
| Some experts consider DCIS a ____________ condition. |
|
Definition
|
|
Term
| What is the prognosis for DCIS? |
|
Definition
almost all women can be successfully treated and no evidence suggests that it affects a woman's life span
if left untreated, it may eventually develop into invasive breast cancer |
|
|
Term
| abnormal cells are contained within a lobule of the breast but haven't invaded the surrounding breast tissue |
|
Definition
| lobular carcinoma in situ (LCIS) |
|
|
Term
| What is the controversy surrounding LCIS? |
|
Definition
| whether it is an early form of breast cancer or is just a marker for the future development of cancer |
|
|
Term
| What do experts agree on about LCIS in terms of prognosis? |
|
Definition
| pts. with LCIS are at an increased risk of developing invasive breast cancer in either breast in the future |
|
|
Term
| If a pt. has LCIS in the right breast, what type of cancer is most likely to develop in the right breast? |
|
Definition
| invasive lobular carcinoma |
|
|
Term
| If a pt. has LCIS in the right breast, what type of cancer is most likely to develop in the left breast? |
|
Definition
| either invasive ductal carcinoma or invasive lobular carcinoma |
|
|
Term
| What type of cancer accounts for the majority of invasive breast cancers? |
|
Definition
| invasive ductal carcinoma (IDC) |
|
|
Term
|
Definition
| cancer cells form in the lining of the milk duct, break free of the ductal wall, and invade surrounding breast tissue |
|
|
Term
| What type of spread is typical of IDC? |
|
Definition
| lymphatic and hematogenous |
|
|
Term
| What type of breast cancer can be mistaken for mastitis? |
|
Definition
| inflammatory breast cancer |
|
|
Term
|
Definition
receptor seen on path report
If cancer is HER2/neu +, it will respond to Herceptin. |
|
|
Term
|
Definition
done on path report to show if cancer is estrogen/progesterone sensitive
If the cancer is ER/PR +, it will respond to Tamoxifen. |
|
|
Term
| What cancer markers are used in breast cancer? |
|
Definition
|
|
Term
| What blood work should be ordered for a metastatic work up in a pt. with breast cancer? |
|
Definition
|
|
Term
| What imaging studies should be done for metastatic work up in a pt. with breast cancer? |
|
Definition
total body bone scan
CT chest/abdomen with and w/o contrast
(occasionally do whole body CT)
PET scan |
|
|
Term
| What does TNM classification stand for? |
|
Definition
|
|
Term
| What is the 5 year survival rate for a pt. with Stage 0 (DCIS) breast cancer? |
|
Definition
|
|
Term
| What is the 5 year survival rate for a pt. with Stage 1 breast cancer? |
|
Definition
|
|
Term
| What is the 5 year survival rate for a pt. with Stage 2 breast cancer? |
|
Definition
|
|
Term
| What is the 5 year survival rate for a pt. with Stage 3 breast cancer? |
|
Definition
|
|
Term
| What is the 5 year survival rate for a pt. with Stage 4 breast cancer? |
|
Definition
|
|
Term
| What is the most commonly used anti-estrogen drug for breast cancer treatment? |
|
Definition
|
|
Term
| What medication can be used in a women who is at high risk of getting breast cancer but who has not had it before? |
|
Definition
|
|
Term
| What class of drugs stops estrogen production in postmenopausal women? |
|
Definition
aromatase inhibitors
letrozole (Femara)
anastrozole (Arimidex)
exemestane (Aromasin) |
|
|
Term
| Are aromatase inhibitors effective in premenopausal women? Why or why not? |
|
Definition
| no, because they cannot stop the ovaries of premenopausal women from making estrogen |
|
|
Term
| What drug targets the HER2/neu protein? |
|
Definition
|
|
Term
| What drug targets tumor angiogenesis? |
|
Definition
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