Breast Disorders and BIRADS Quiz

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Questions and Answers

What clinical sign indicates involvement of Cooper's ligaments in breast disorders?

Dimpling

In which condition are the superficial lymphatics involved, leading to a peau d'orange appearance?

Inflammatory breast cancer

What BIRADS score indicates incomplete imaging and what is its recommended action?

BIRADS 0; Additional imaging is required

When using the dial clock method for breast examination, what age group is it primarily recommended for?

<p>40 years and older</p> Signup and view all the answers

For a BIRADS score of 3, what follow-up is recommended and what is the associated risk of cancer?

<p>Follow up after 6 months; Risk of cancer is 20%</p> Signup and view all the answers

What is the significance of BRCA1 and BRCA2 gene mutations in breast cancer?

<p>BRCA1 is primarily associated with breast cancer, while BRCA2 increases the risk for breast, ovarian, and potentially pancreatic cancers.</p> Signup and view all the answers

List two imaging indications for using MRI in the context of breast cancer.

<p>MRI is indicated for detecting local recurrence and for young, high-risk patients in screening.</p> Signup and view all the answers

How does age relate to breast cancer risk according to the risk factors?

<p>Younger age at menarche and later age at menopause are associated with a higher risk of breast cancer.</p> Signup and view all the answers

What is the role of Ki-67 in breast cancer assessment?

<p>Ki-67 serves as a proliferation index marker indicating cell multiplication and is used to gauge tumor aggressiveness.</p> Signup and view all the answers

Identify the most common type of breast cancer and its origin.

<p>The most common type of breast cancer is invasive ductal carcinoma, originating from the terminal duct lobular unit.</p> Signup and view all the answers

What molecular characteristics define the Luminal A subtype of breast cancer?

<p>Luminal A subtype is characterized by positive expression of ER and PR, and low levels of Ki-67.</p> Signup and view all the answers

Explain the relationship between smoking and breast cancer risk.

<p>Smoking is linked to an increased risk of breast cancer as well as other conditions like duct ectasia and Mondor's disease.</p> Signup and view all the answers

What is the recommended action when 21 or more blood relatives are diagnosed with breast cancer before age 55?

<p>It is recommended to conduct BRCA testing for potential genetic mutations.</p> Signup and view all the answers

Flashcards

Incisional Biopsy

A type of biopsy where a small piece of tissue is removed from the breast using a small instrument.

Tru-cut/Core Needle Biopsy

A type of biopsy where a core of tissue is removed from the breast using a needle.

Early Menarche

Early onset of menstruation, usually before 12 years of age.

Hormone Replacement Therapy (HRT)

A hormone replacement therapy used to manage menopausal symptoms.

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Triple Negative Breast Cancer (TNBC)

A type of breast cancer that does not express estrogen receptors (ER), progesterone receptors (PR), or the HER2 protein.

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HER2

A protein found in breast cancer cells that can help predict how aggressive the cancer is.

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Estrogen Receptor (ER)

A protein that binds to estrogen and plays a role in breast cancer development.

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Progesterone Receptor (PR)

A protein that binds to progesterone and plays a role in breast cancer development.

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Dimpling of the breast

A pattern of small indentations on the skin of the breast caused by the shortening and thickening of the ligaments of Cooper, often a sign of invasive breast cancer.

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Retraction of Breast Tissue

A pulling inward of the skin of the breast, usually caused by the contraction of the lactiferous ducts due to tumor infiltration. This can also indicate cancer.

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Peau d'Orange (PDO)

A thickened, dimpled, or orange peel-like texture on the breast, commonly caused by edema in the lymphatic vessels beneath the skin.

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What is BIRADS?

A system used to categorize breast imaging findings based on their likelihood of being cancerous. It uses categories 0-6 to describe the probability of malignancy.

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What is the 'Dial Clock' method?

A technique used to assess the breast by systematically palpating the area, dividing it into imaginary quadrants and performing circular motions in a clock-wise pattern.

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Study Notes

Breast Cancer

  • Most common type: Invasive ductal carcinoma
  • Origin: Terminal duct lobular unit (Tolu)
  • Quadrants affected: Upper outer, lower inner, upper inner, lower outer

Genetic Mutations

  • Breast cancer:

    • Sporadic (90%): no known mutation
    • Familial (10%):
      • BRCA1
      • BRCA2
      • TP53
      • PTEN
  • Indications for BRCA testing:

    • Patient with BRCA1/2 gene mutation in a blood relative
    • History of ovarian, fallopian tube, or peritoneal cancer
    • 21 or more blood relatives diagnosed with breast cancer
    • 50 or more blood relatives diagnosed with breast cancer at 550 years
    • Triple negative breast cancer at 500 years
    • Male breast cancer

Immunohistochemistry (IHC)

  • ER: Measured with Alcian blue (steroid receptor)
  • HER 2 neu: Cell membrane stains brown (membraneous receptor)
  • Ki 67: Proliferation index marker

Molecular Subtypes

  • Based on gene expression profiling: Luminal A, Luminal B, Basal like (TNBC), HER2 enriched, etc.

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