COURS IFSI

Anglais médical – Tout sur le cancer du sein


Régulièrement, cette rubrique animée par Virginia Allum, auteur et consultante EMP (English for Medical Purposes), vous permettra, exercices à l'appui, de parfaire votre anglais médical au travers de situations de soins concrètes. Bon travail à tous !

N'hésitez pas à vous servir du dictionnaire en ligne Wordreference.
Vous trouverez à la fin de cet article les corrections des exercices qui vous sont proposés téléchargeables au format pdf.

Activity 1 - Talking about breast cancer

What do you already know about breast cancer ?

Answer the following questions from your knowledge

  1. Does breast cancer affect only women ?
     
  2. What is the name of the radiological procedure which screens for breast cancer ?
     
  3. What does ‘mastectomy’ mean ?
     
  4. Breast cancer is caused by stress and activities like smoking. True or False ?

Activity 2 - Breast anatomy

Before you start, review the following terms

areola
 
from area = open area
 
lobule
 
from lobulus =small lobe. A lobe is a small, rounded segment
 
pector-
 
medical term meaning breast
 
galacto-
 
milk
 
lacto-
 
milk
 

Label the picture of a breast using the words below

credit photo wikipédia

fat lobules ; milk duct ; skin ; chest wall ; nipple ; subcutaneous fat ; pectoralis muscle ; areola

  1. ______________________________

     
  2. ______________________________

     
  3. ______________________________

     
  4. ______________________________

     
  5. ______________________________

     
  6. ______________________________

     
  7. ______________________________

     
  8. ______________________________
     

Activity 3 - What is breast cancer ?

Breast cancers are now thought to be not one but ten different diseases. A recent study funded by Cancer Research UK has identified ten different categories of breast cancer called IntClust one to 10. The reclassification of breast cancers is hoped to lead to better targeted therapy and longer survival rates. The majority of breast cancers are diagnosed in women with a small number of breast cancers diagnosed in men.

Breast cancers usually develop in the milk-producing glands and ducts that carry milk from the glands to the nipple. Cancers develop as a result of damaged cells, which can grow uncontrollably to form a lump or thickening called a tumour.

Many different factors contribute to the development of breast cancer and hormones such as oestrogen often play an important role. Breast cancer cells may form metastases or ‘secondaries’ in other parts of the body if untreated or if treatment fails. The lymph nodes in the axilla are a common place for secondary tumours.
Currently, breast cancers are classified by their appearance under a microscope and the presence or absence of tumour markers. More than 70% of tumours respond to hormone therapies such as tamoxifen for tumours with "oestrogen receptors" and Hercetin for tumours with a "Her2 receptor".

Read the text and then complete the informations about breast cancer using

metastases ; hormone therapy ; targeted ; hormones ; milk-producing

A recent study suggests that breast cancers are several different diseases which require _______________________________ therapy to be treated successfully. Most breast cancers develop in the _______________________________ glands of the breasts. Female _______________________________ such as oestrogen often play an important role in the development of breast cancer. Secondary tumours called _______________________________ may form in other parts of the body if the breast cancer is untreated. Most tumours respond to _______________________________ such as tamoxifen.

Activity 4

Match the terms on the left with their meanings on the right

 

1. primary cancer
 
a. milk-producing
 
2. targeted therapy
 
b. secondary cancers which develop in another site of the body
 
3. prognosis
 
c. armpit or under-arm
 
4. metastasis
 
d. the main cancer or cancer which develops first
 
5. lactiferous
 
e. substance in blood or urine which indicates the presence of cancer
 
6. axilla
 
f. survival rate or time a person lives after treatment of cancer
 
7. tumour marker
 
g. treatment which is specific to the type of tumour
 

Activity 5 - The development of breast cancer

développement du cancer du sein schéma

Match the pictures 1 – 5 with the descriptions a – e

 

1. Lump
 
a) Haemoserous fluid leaking from the breasts is a serious sign of breast cancer
 
2. Skin dimpling
 
b) The nipple of the affected breast may change position as well as becoming introverted
 
3. Skin texture
 
c) Breast tissue is sometimes drawn into the surrounding tissue creating a hollow or dimple in the breast
 
4. The nipple
 
d) The first symptom many women discover is a lump that feels different from the rest of the breast tissue
 
5. Fluid leakage
 
e) Changes in the feel of the skin around the breast is called ‘orange peel’ skin
 

Activity 6 - Breast cancer surgery

Before undergoing a mastectomy, a biopsy or removal of cells for examination is undertaken. A common type of biopsy is called the needle biopsy which is performed by inserting a needle into the breast tissue and withdrawing some fluid which is examined by a pathologist who checks for abnormal breast cells. If a larger sample of tissue is needed, an excisional biopsy is performed to remove a lump or large area of breast tissue. Biopsies are useful to exclude fibrocystic breast changes which are benign and therefore do not require mastectomy.

Should it be necessary to remove part or all of the breast , several types of surgery are available. The least radical is breast-conserving surgery. This includes lumpectomy or removal of a breast lump, quadrantectomy or removal of a quadrant of the breast and segmental mastectomy. Segmental mastectomy removes the tumour, some of the surrounding tissue and also some of the lining of the chest muscle .

Removal of the breast is called mastectomy . There are different types of mastectomy depending on the status of the tumour and whether lymph nodes are involved. Tumours which have not spread at all are called carcinoma in situ meaning ‘tumour in its place’. Surgery which removes the entire breast but leaves the pectoral muscles is called modified radical mastectomy . By leaving the chest muscle intact, breast reconstructive surgery can be attempted later. Reconstructive surgery such as tissue flap reconstruction moves a flap of tissue from another part of the body to the chest so that a breast mound can be formed. Sometimes a nipple flap can also be done or, if this is not possible, nipple tattooing approximates the shape and colour of a nipple for a better aesthetic effect.

Read the text then complete the following questions

  1. The best summary of paragraph 1 is :
    1. A mastectomy is performed as soon as breast cancer is suspected.
    2. (Before performing a mastectomy, a biopsy of breast tissue is examined for the presence of abnormal cells.
    3. All changes in breast tissue are abnormal and are therefore treated by removal of the breast.
       
  2. The best summary of paragraph 2 is :
    1. Breast cancer surgery always requires removal of the entire breast and surrounding chest muscle.
    2. It is more common for bilateral mastectomy or removal of both breasts to be performed as a precaution.
    3. Breast cancer which is localised can be treated by removal of a breast lump or removal of a segment of the breast while conserving as much of the breast as possible.
       
  3. The best summary of paragraph 3 is :
    1. Modified radical mastectomy allows for later reconstructive breast surgery using the pectoralis muscle .
    2. Removal of the breast includes removal of the nipple and chest muscle.
    3. Many women have a nipple tattoo after mastectomy to improve their body image.

Activity 7

Before you start, review these terms

masto-
 
breast
 
onco-
 
cancer
 
-plastic
 
relating to the formation of something
 

Mastectomy drug trial tests begin at the Royal Cornwall Hospital

New treatment for breast cancer patients could be rolled out nationwide if a study in Cornwall proves successful. The Royal Cornwall Hospital in Truro has been given £250,000 to trial a new technique, known as the "painbuster".
The procedure, which takes place in the first 48 hours after a mastectomy is being tested on 160 women from Cornwall and Devon. Morphine will be replaced with a local anaesthetic stored in a small gadget.
'Simple technique'
The gadget, which is worn on the patient's nightgown, slowly releases the anaesthetic directly to the area where the surgery has been carried out. Iain Brown, a consultant oncoplastic surgeon at the Royal Cornwall Hospital, said: "We know morphine is not a great thing to have in your system when you're trying to get over a big operation.
"We want our patients to wake up, sit up in bed, brush their hair and put their make-up on. If they can do that from the beginning it makes them feel great psychologically."
The hospital has been given the funding from the National Institute of Health Research to carry out the study. Those carrying out the trial hope it will reduce the amount of time it takes women to recover from a mastectomy. Roger Langford, a consultant anaesthetist at the hospital, said: "What we're hoping is the results are positive and this technique is beneficial. Then other centres can see what is a relatively simple technique, will be easy to take on and benefit their patients as well."

The text is taken from BBC Health at www.bbc.co.uk

Read the text and answer the questions which follow

  1. Is the new treatment a breast cancer drug or a pain management device?
     
  2. When is the pain buster used?
     
  3. What is released in the pain buster?
     
  4. What two reasons are given for why the pain buster is thought to be a better post-operative treatment for mastectomy patients?
     

Activity 8 - Reading academic articles

Read the following article taken from www.biomedcentral.com.

An investigation of the apparent breast cancer epidemic in France : screening and incidence trends in birth cohorts

Bernard Junod 1, Per-Henrik Zahl 2, Robert M Kaplan 3, Jørn Olsen 4 and Sander Greenland 4, 5

Abstract

Background
Official descriptive data from France showed a strong increase in breast-cancer incidence between 1980 to 2005 without a corresponding change in breast-cancer mortality. This study quantifies the part of incidence increase due to secular changes in risk factor exposure and in overdiagnosis due to organised or opportunistic screening. Overdiagnosis was defined as non progressive tumours diagnosed as cancer at histology or progressive cancer that would remain asymptomatic until time of death for another cause.

Methods

Comparison between age-matched cohorts from 1980 to 2005. All women residing in France and born 1911-1915, 1926-1930 and 1941-1945 are included. Sources are official data sets and published French reports on screening by mammography, age and time specific breast-cancer incidence and mortality, hormone replacement therapy, alcohol and obesity. Outcome measures include breast-cancer incidence differences adjusted for changes in risk factor distributions between pairs of age-matched cohorts who had experienced different levels of screening intensity.

Results

There was an 8-fold increase in the number of mammography machines operating in France between 1980 and 2000. Opportunistic and organised screening increased over time. In comparison to age-matched cohorts born 15 years earlier, recent cohorts had adjusted incidence proportion over 11 years that were 76% higher [95% confidence limits (CL) 67%, 85%] for women aged 50 to 64 years and 23% higher [95% CL 15%, 31%] for women aged 65 to 79 years. Given that mortality did not change correspondingly, this increase in adjusted 11 year incidence proportion was considered as an estimate of overdiagnosis.

Conclusions

Breast cancer may be overdiagnosed because screening increases diagnosis of slowly progressing non-life threatening cancer and increases misdiagnosis among women without progressive cancer. We suggest that these effects could largely explain the reported "epidemic" of breast cancer in France. Better predictive classification of tumours is needed in order to avoid unnecessary cancer diagnoses and subsequent procedures.

Notes

Corresponding author: Bernard Junod Junod.bernard@wanadoo.fr
Author Affiliations :

  1. FORMINDEP, Roubaix, France. Previous position: Department of Epidemiology, Ecole des Hautes Etudes en Sante Publique Rennes, France
  2. Norwegian Institute of Public Health, Oslo, Norway
  3. UCLA Schools of Public Health and Medicine, Los Angeles, USA
  4. Department of Epidemiology, UCLA School of Public Health, Los Angeles, USA
  5. Department of Statistics, UCLA College of Letters and Science, Los Angeles, USA

For all author emails, please log on.
BMC Cancer 2011, 11:401 doi:10.1186/1471-2407-11-401

Read the summary and then answer the questions that follow

Using the topic sentences (first sentence) of each paragraph, a summary has been generated :

Official descriptive data from France showed a strong increase in breast-cancer incidence between 1980 to 2005 without a corresponding change in breast - cancer mortality. Comparison between age-matched cohorts from 1980 to 2005. All women residing in France and born 1911-1915, 1926-1930 and 1941-1945 are included. There was an 8-fold increase in the number of mammography machines operating in France between 1980 and 2000. Breast cancer may be overdiagnosed because screening increases diagnosis of slowly progressing non-life threatening cancer and increases misdiagnosis among women without progressive cancer.

  1. Was there an increase in breast cancer and corresponding deaths from breast cancer in France between 1980 and 2005 ?
    1. Yes, there was an increase in the incidence of breast cancer and deaths relating to breast cancer during those years.
    2. There was a rise in deaths from breast cancer between the years of 1980 and 2005.
    3. There appeared to be an increase in the numbers of women diagnosed with breast cancer with no increase in the number of deaths relating to breast cancer.
       
  2. The sample of women used for the study of screening and incidence of breast cancer were taken from :
    1. French citizens born in three cohorts between 1911-1915, 1926-1930 and 1941-1945.
    2. any women who had lived in France between 1911-1915, 1926-1930 and 1941-1945.
    3. women of French background who were born between 1911-1915, 1926-1930 and 1941-1945.
       
  3. A factor which may have contributed to the increase in numbers of breast cancer diagnoses is :
    1. the increase in mastectomies during the time period.
    2. the increase in mammograms during the time period.
    3. the increase in lactation specialists during the time period.
       
  4. The study suggests that
    1. more women should have been screen earlier.
    2. more women have been saved by the increase in mammography.
    3. the increase in screening for women may have lead to an overdiagnosis of progressive and life-threatening breast cancers and misdiagnosis of non-progressive breast cancers.

Activity 9

Find words in the text which have the same meaning as the following words


1. death

________________________________________________

2. study of tissues of the body

________________________________________________

3. groups of people

________________________________________________

4. overweight

________________________________________________

5. eight times

________________________________________________

6. worsening

________________________________________________

7. incorrect diagnosis

________________________________________________

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Author and Consultant in English for Medical Purposes
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