Latest - (Latest / 1. What is the incidence of breast c...

Breast Cancer (Smarty PANCE) (Latest /

• What is the incidence of breast cancer?

Answer: 12% Lifetime Risk

• Percentage of women with breast cancer who have zero known risk factors?

Answer: 75%

• Percentage of all breast cancers in women <30 years?

Answer: ~2%

• Percentage of all breast cancers in women >70 years?

Answer: 33%

• Percentage of breast cancers due to inherited mutations?

Answer: 10%

• Approximate percentage of inherited breast cancers due to BRCA 1/2?

Answer: -~50% (5% of all breast cancers)

• What is the expected ER status of BRCA 1 vs BRCA 2 breast cancers?

Answer: -BRCA 1 ER negative (~70%) BRCA 2 ER positive (~70%)

• Name some breast cancer susceptibility genes

Answer:

BRCA 1/2 Tp53 (Li Fraumeni) PTEN STK11 (Peutz-Jeghers) PTALB CDH1

• How do you decrease breast cancer risk in women with BRCA mutations?-

Answer: Prophylactic bilateral mastectomy (90% risk reduction)

+prophylactic BSO -> 95% risk reduction

Rule o' Thumb: 5 years before the earliest onset of cancer in mom

• What is the preferred screening for mutation carriers?

Answer: MRI annually

• Most common motivation for medicological cases of the breast

Answer: Failure to diagnose a breast carcinoma 1 / 2

• Triad of Error for misdiagnosis of breast cancer

Answer:

1) Age <45 years 2) Self-diagnosed mass 3) Negative mammogram

• Hx breast cancer risk factors?

Answer: NAACP Nulliparity

Age at menarche (<13 yrs) Age at menopause (>55 yrs) Breast cancer (self, family) Pregnancy of 1st child >30yrs

• Physical breast cancer risk factors?

Answer: CHAFED LIPS

Cancer in breast (3% synchronous contralat) Hyperplasia (2x) Atypical hyperplasia (4x) Female (100x) Elderly

DCIS LCIS Inherited genes Papilloma (1.5x) Sclerosing adenosis (1.5x)

• Relative risk of hormone replacement therapy?

Answer: 1 - 1.5

• Is normal fibrocystic disease a risk factor for breast cancer?

Answer: No

• What are the possible symptoms of breast cancer?

Answer:

No symptoms Mass in the breast Pain (most are painless) Nipple discharge Local edema Nipple retraction Dimple Nipple rash

• What causes skin retraction?

Answer: Tumor involvement of Cooper's ligaments causing subsequent inward traction on skin

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