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Cancer

Cancer. Screening Grading Breast + GI cancers. Vivian Phan. Screening. Grading. = Degree of differentiation How closely do tumour cells resemble normal tissue? Varies with specific types of tissue but main principle: Well differentiated = grade 1 Moderately differentiated = grade 2

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Cancer

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  1. Cancer Screening Grading Breast + GI cancers Vivian Phan

  2. Screening

  3. Grading =Degree of differentiation • How closely do tumour cells resemble normal tissue? • Varies with specific types of tissue but main principle: • Well differentiated = grade 1 • Moderately differentiated = grade 2 • Poorly differentiated = grade 3

  4. Breast: Adeno- (glandular/columnar epithelium) • Benign: most common = Fibroadenoma • Non-invasive/ in situ carcinoma • Malignant=Adenocarcinoma • Paget’s disease of the nipple • 50% have underlying invasive malignancy • Risk factors • Age • FH • Unopposed oestrogen (e.g. HRT, obesity)

  5. Breast: Staging: TNM • T = tumour size • T1 • T2 • T3 • N = nodal involvement • N0 = no • N1 = yes • M = metastasis • M0 = no • M1 = yes • Nottingham Prognostic Index • Size x0.2 • Score for nodes • Grade (1-3)

  6. Breast cancer pathology report • Type: ductal or lobular • Whole size • Invasive size: T1-T3 • Grade: 1-3 • Nodal involvement • Vascular invasion • Receptor status: Oestrogen, Progesterone • HER-2 status • Nottingham Prognostic Index

  7. GI: mostly adenocarcinoma (exceptions at either end of tract) • Oesophageal: adenocarcinoma, SCC • Gastric: adenocarcinoma, MALT lymphoma • Pancreatic: ductal adenocarcinoma • Liver: secondary, hepatocellular carcinoma • Biliary tract: GB adenocarcinoma, cholangiocarcinoma • Colorectal adenocarcinoma • Anal: adenocarcinoma above pectinate line, SCC below

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