255b advanced breast cancer

Question 1

what stage is breast cancer that has spread to chest wall or is inflammatory but hasn’t spread to other parts of the body?

Answer 1

IIIB

Question 2

can people with IIIB breast cancer have long term survival?

Answer 2

yes, with neoadjuvant chemo to shrink tumor before surgery (inop tumor –> oper tumor)

Question 3

ER+ BC Rx

Answer 3

Endocrine - Tamoxifen

then chemotherapy when patient no longer responds

Question 4

HER2+ BC Rx? target? toxicity?

Answer 4

Anti-HER2 - Trastuzumab (trasTWOzumab)

HER-2 is a tyrosine kinase receptor

damages the heart

Question 5

triple negative BC Rx

Answer 5

chemotherapy

Question 6

are most BC either ER+ or PR+

Answer 6

yes, ~75% –> better odds of endocrine treatment working

Question 7

source of estrogen in BC?

Answer 7

premenopause - ovaries

postmenopause - adrenal gland w/ aromatase conversion

Question 8

tamoxifen

Answer 8

• at Breast
  + at endometrium (carcinoma)
  + at Bone

(Raloxifene is - at breast and endometrium)

Question 9

aromatase inhibitor side effects

Answer 9

decreases E in post-menopausal women so causes increased symptoms of menopause

hot flashes, arthralgias, loss of bone, vaginal dryness

Question 10

should you rebiopsy in metastatic BC?

Answer 10

yes, tumor cells can change and become more or less susceptible to varying therapies

Question 11

denosumab - target? clinical use? notes?

Answer 11

RANK-L (from OB to OC)

osteoporosis - inhibits OC maturation (mimics osteoprotegrin)

DEN-OS-umab DENies OSteoclasts