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Glossary of system path pink

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Created by billychoi85

Estrogen/androgen imbalance
Normal and abnormal circumstances: including puberty, very aged, or when hyperestrinism T
Cirrhosis of liver*
Older males, relative increase in adrenal estrogens as androgenic function of testis fails




Gynecomastia
2-4 cm
Mobile, rubbery
Diagnosis: needle biopsy/aspiration
10-15% multiple
BENIGN





Fibroadenoma
Staph aureus: localized erythema + single or multiple abscesses
Streptococcal infections: diffuse erythema
Breast is tender, swollen
Lactating females
Fever





Mastitis
intraductal benign, can give bloody disc harge



Papilloma
‘Eczematous’ nipple
60% palpable mass




Paget’s Disease of Breast
risk factors for breast cancer
-Obesity: premenstrual its protective, postmenopausal NOT
-Reproductive/hormonal factors
a)Menarche before age 12 not good
b)Age at first live birth best if 18-20,


Menarche before age 12 not good
Age at first live birth best if 18-20,
risk factors for breast cancer
key to breast cancer is hormone exposure



Major risk factors: hormone exposure
Majority of these: postmenopausal and overexpress ER (estrogen receptor)


Epidermal growth factor receptor superfamily erb82

can target for therapy





HERS-2
classification of breast cancer







Adenocarcinoma - majority Squamous cell, sarcomas, lymphomas < 5% In situ vs invasive In situ: limited to ducts and lobules by basement membrane
Estrogen + progesterone receptors*** 50-85% of CA express estrogen receptor (ER) in postmenopausal. Slightly better prognosis. With neither receptor, < 10% chance of response
factors for breast cancer
treatments =
SURGERY: may use sentinel node vs lymph node dissection

2 types =






A) lumpectomy or breast sparing– only abnormal tissue is removed with clean margins
B) Mastectomy—removal of entire breast; radical mastectomy: breast + muscles are removed from chest wall
vs modified radical mastectomy (MRM) - chest muscles are left (preferred)

Treatment - CHEMOTHERAPY



*May shrink tumor sufficiently for breast conserving surgery

Chemotherapy drugs

CMF =

***Common is CMF—cyclophosphamide, methotrexate, 5 fluorouracil

Hormone Therapy



Tamoxifen: estrogen receptor antagonist; selective estrogen receptor modulator
Used to treat and to prevent cancer in those at high risk
Taken x 5 years



Mechanism of Action-Tamoxifen



only given in people who’s estrogen receptors and progesterone receptor positive.

Tamoxifen pearls



Reduces risk of hormonally responsive cancer recurrence by 50%
STOP after 5 years to avoid development of drug-resistant breast tumors or uterine cancer
Stage 1 Breast Cancer



Genetics BRCA 1/BRCA 2 in 15-20% familial breast CA



risk factor
What is BRCA-1



Tumor suppressor gene on chromosome 17 (17q21) involved in gene repair

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