Breast Cancer pathophysiology – Flashcards
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Breast cancer is what # female malignancy?
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#1 Female malignancy #2 cause of mortality
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Is there an increase or decrease in breast cancer?
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decrease (prob dt decrease in HRT)
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African Americans have what characteristics in breast cancer?
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AA more likely to present w higher stage of breast CA, AA higher incidence of "triple negative" breast CA
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Breast Cancer Risk Factors?
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Age,Female, Reproductive/hormonal factors genetic risk factors (10% of breast CA) socioeconomic factors, ? dietary [inc wt after age 18, obesity, high fat, mod EtOH] environmental factors 75% w no RF
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Suspect Hereditary Breast Cancer if... ?
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-Breast + ovarian CA in 1st or 2nd degree relatives -2 first degree relatives w breast CA, one <50 yo -multiple relatives <50 yo w breast CA -Male breast CA -Eastern European Jewish heritage -pt dx prior to age 50 -Triple negative breast CA
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BRCA1
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Chromosome 17 30-40% risk of breast CA 30% risk ovarian CA
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BRCA2
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Chromosome 13 Female 50-80% risk breast CA, 20% risk ovarian CA MALE 10-20% riskbreast CA Eastern European Jewish population founder mutation
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Breast CA risk reduction
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ppx bilateral masectomy (90% reduction) ppx ooporectomy before age 40 (50% breast, 90% ovary)
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Gene Patent
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Myriad Genetics... then led to Sanger ... more expensive... don't always want to know everything
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Breast CA Screening
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Mammogram age 50-69 [not younger bc dense breast = false positive] MRI for high risk women Controversy about screening age 40-49
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BRCA Cancer risk management (high risk, young pts, dense breasts)
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Screening: 2x yrly clinical breast exam (physician exam) @ 25 yo annual breast MRI @30 annual Mammogram
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Breast cancer malignant cells come from what?
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ducts
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Breast cancer surivival prediction is based on what?
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tumor size
