Mock32 Breast Cancer

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Stem
Female patient who underwent mastectomy for breast tumour 5 years ago, as well as parotidectomy for pleomorphic adenoma 10 years ago. Now, she presents with supraclavicular lymph node enlargement.

Investigation?

Tissue biopsy (TRU-cut, FNAC, or excisional biopsy)

Imaging?

MRI & mammogram for the opposite side

What test to be done on FNA?

IHC & FISH (fluorescence in situ hybridization)
Hormonal receptor (ER/PR)
HER2 receptor

Which receptors?

HER2 receptors status - poor prognosis
ER/PR receptor status - good prognosis

Why is ER important?

Prognosis
Treatment strategy

What is HER2?

Transmembrane Human Epidermal growth factor Receptor 2.
Oncogene, biomarker.
It is overexpressed in 15% of breast cancer cases
Associated with bad prognosis (They're less likely to be sensitive to hormone therapy).

Differences between histology and cytology?

See parotid station

When cytology is deemed inconclusive?

See parotid station

What is C1, 2, 3, 4, 5?

C1 - inadequate sample
C2 - benign
C3 - equivocal
C4 - suspicious
C5 - malignant

What is adenocarcinoma?

Malignant tumour
Formed from glandular structures in epithelial tissue

What is the relation between pleomorphic adenoma and breast adenocarcinoma?

See Parotid station

What hormonal therapy to give in pre- and post-menopausal?

Premenopausal: Tamoxifen
Postmenopausal: Aromatase inhibitors (anastrozole).

Patient has redness around nipple, what does it mean?

Eczema
Paget disease

What is the pathophysiology of Paget disease?

It is caused by the extension of DCIS up the lactiferous ducts and into the contiguous skin of the nipple.
Producing a unilateral crusting exudate over the nipple and areolar skin.

Gene will give you instructions to make protein which is apart of family of tyrosine kinase receptor
PDGFRA

isurg

Mock32 Breast Cancer