1. Cancer -Screening -Grading -Breast + GI cancers Vivian Phan

2. Screening CancerWhoHowWhatIf abnormal Cervix25-65SmearDysplasia/ dyskaryosis Colposcopy Breast50-69Self Mammogram Colorectal60-75FOBBlood!Colonoscopy/ Sigmoidoscopy

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