Breast cancer screening

Background of breast cancer

Type Clinical features 
Risk factors 
  • Increasing age 
    • Increased risk after age 50 
  • Female sex 
    • Cancer 100 times more likely in women compared to men 
  • Personal history of breast cancer 
    • Increased risk of development in contrlateral breast 
  • Inherited genetic mutations 
    • BRCA1, BRCA2, BRCA3 
    • CDH11 
    • p53 
    • PALB2 
    • PTEN 
    • STK11 
  • Delayed menopause 
  • Dense breast tissue 
  • Early menarche 
  • Exposure to ionizing radiation to chest between ages 10-30 
  • Family history of breast cancer in first-degree female relatives 
  • Increased age of first pregnancy 
  • Increased alcohol consumption 
  • Increased endogenous estrogen levels 
  • Nulliparity 
  • Obesity 
  • Smoking 
Common breast cancer pathology 
    • Most common type of invasive breast cancer (70-80%) 
    • Cords and nests of cells o histology with varied glandular formation 
    • Small cells on histology that invade mammilary glands and adipose tissue in linear pattern 
  • Mixed ductal/lobular carcinoma 
    • Also referred to as mixed invasive carcinoma with both ductal and lobular carcinoma characteristics 
Molecular subtypes 
  • Luminal subtypes 
    • Majority of estrogen receptor (ER) and progesterone receptor (PR) positive cancers 
    • Types A and B 
  • Human epidermal growth factor receptor 2 (HER2) enriched 
    • High expression of proliferating gene clusters and low luminal subtype expression 
    • Often ER/PR negative 
  • Basal subtypes (triple negative breast cancer) 
    • Negative for ER, PR, and HER2 

 

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