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RDS Test 3 > B8-039 CBCL Breast Cancer > Flashcards

B8-039 CBCL Breast Cancer Flashcards

1
Q

the T category of staging is mostly driven by

A

size

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2
Q

the N category of staging signifies

A

regional lymph node involvement

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3
Q

the M category of staging signifies

A

presence of distant metastasis

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4
Q

BRCA1 positive individuals are most likely to develop what type of breast cancer?

A

basal-like

(large % of these are triple negative)

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5
Q

BRCA2 positive individuals are most likely to develop what type of breast cancer?

A

luminal B

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6
Q

individuals with sporadic cases are most likely to develop what type of breast cancer?

A

Luminal A
followed by Luminal B

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7
Q

tumors from the lateral half of the breast are more likely to drain into the […] lymph nodes

A

axillary

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8
Q

tumors from the medial half of the breast are more likely to drain into the […] lymph nodes

A

internal mammary

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9
Q

defines lymph nodes lateral to pectoralis minor muscle

A

Ax I

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10
Q

defines lymph nodes behind pectoralis minor and to the broader space between minor and major

A

Ax II

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11
Q

defines lymph nodes medial to pectoralis minor muscle

A

Ax III

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12
Q

lymph node […] is becoming increasingly more frequent due to studies showing equal efficacy with lymph node dissection

A

radiotherapy

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13
Q

chemotherapy given after surgery

A

adjuvant

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14
Q

chemotherapy given before surgery

A

neoadjuvant

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15
Q

do patients with DCIS or early stage breast cancer who underwent mastectomy typically need radiation?

A

no

(vs. lumpectomy, yes)

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16
Q

what types of patients will require radiation therapy?

A

patients who received lumpectomy
patients with positive lymph nodes

some patients who get masectomy with high risk factors

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17
Q

hallmark of DCIS

A

cancer cells have not penetrated outside the myoepithelial layer and basement membrane

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18
Q

microcalcifications are seen on mammagraphy in [DCIS/LCIS]

A

DCIS

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19
Q

loss of E-cadherin is associated with [DCIS/LCIS]

A

LCIS

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20
Q

diffuse cytoplasmic expression of p120 catenin is associated with [DCIS/LCIS]

A

LCIS

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21
Q

Malignant proliferation of cells in ducts with no invasion of the basement membrane

A

DCIS

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22
Q

DCIS does not usually produce a mass, and so is usually seen as […] on mammography

A

calcification

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23
Q

subtype of DCIS characterized by high-grade cells with necrosis and dystrophic calcification in the center of ducts

A

comedo type

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24
Q

subtypes of DCIS are based on […]

A

architecture

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25
Paget disease of the breast is [...] that extends up the ducts to involve the skin of the nipple
DCIS
26
Malignant proliferation of cells in lobules with no invasion of the basement membrane
LCIS
27
[DCIS/LCIS] does not produce a mass or calcifications and is usually discovered incidentallyon biopsy.
LCIS
28
Characterized by dyscohesive cells lacking E-cadherin adhesion protein
LCIS
29
used to assess axillary lymph nodes
sentinel lymph node biopsy
30
[...] is the most important prognostic factor, but [...] is the most useful prognostic factor
[metastasis] is the most important prognostic factor, but [spread to axillary node] is the most useful prognostic factor
31
only [...]% of breast cancer is caused by inherited mutations
10 90% is sporadic
32
what molecular subtype has the best prognosis?
Luminal A (ER+/PR+)
33
[what subtype] ER+/PR+
Luminal A
34
[what subtype] ER+/ PR + or -
Luminal B
35
[what subtype] Her2+
ErbB2/Her2
36
[what subtype] ER- /PR- /Her2-
triple negative (basal)
37
what molecular subtype has the worst prognosis?
triple negative ER- /PR- /Her2-
38
estrogen antagonists for ER+ breast cancer [2]
tamoxifen fulvestrant
39
aromatase inhibitors [3]
anastrozole exemestane letrozole
40
Her2 antibody therapies [2]
Herceptin (trastuzumab) pertuzumab
41
aromatase inhibitors are used primarily in [...] women to prevent peripheral conversion of estrogen
postmenopausal
42
tamoxifen as an antagonist at the [...] and agonist at the [...]
tamoxifen as an antagonist at the [breast] and agonist at the [uterus and bone]
43
what is the difference in the MOA of tamoxifen and fulvestrant?
tamoxifen is an ER receptor antagonist fulvestrant degrades the ER receptor
44
second-line therapy used for tamoxifen resistant breast cancers
fulvestrant
45
LHRH analogs used in premenopausal women with ER+ breast cancer for ovarian suppression [3]
leuprolide goserelin triptorelin
46
treatment of ER+ breast cancer in premenopausal women
tamoxifen +/- ovarian suppression
47
treatment of ER+ breast cancer in postmenopausal women
tamoxifen or aromatase inhibitors fulvestrant if needed
48
Clinical features that suggest hereditary breast cancer [3]
multiple first-degree relatives with breast cancer tumor at an early age (premenopausal) multiple tumors in a single patient.
49
[...] mutation is associated with breast and ovarian carcinoma
BRCA1
50
[...] mutation is associated with breast carcinoma in males
BRCA2
51
most important single gene mutations associated with hereditary breast cancer [2]
BRCA1/2
52
patients with genetic predisposition to breast cancer may elect to undergo double mastectomy, but a small risk for cancer remains because [...]`
breast tissue sometimes extends into the axilla or subcutaneous tissue of the chest wall.
53
what are the molecular subtypes of breast cancer? [4]
luminal A (ER+/PR+) luminal B (ER+/PR-) Her2 + triple negative
54
most breast cancers are driven by activation of the [...] hormone receptor
estrogen
55
binds to extracellular domain of the Her2 protein and stops it from being activated
trastuzumab
56
monocolonal antibody used to treat Her2+ breast cancers
trastuzumab
57
BIRAD score of 3 is consistent with high probability of being [...]
benign
58
DCIS and LCIS are associated with a [...]x risk for invasive breast cancer
9-10
59
most patients that present with Pagets have underlying [...]
DCIS or invasive carcinoma (90%)
60
atypical ductal hyperplasia is associated with [...]x risk for invasive breast cancer
4-5
61
most aggressive subtype of DCIS
comedonecrosis
62
BIRAD score of 4 is consistent with reasonable probability of being [...]
malignant biopsy recommended
63
treatment recommendations for atypical ductal hyperplasia
annual mammograms tamoxifen
64
a hallmark of [...] is positive E-cadherin
DCIS
65
does usual ductal hyperplasia increase risk of breast cancer?
yes
66
most common cause of breast pain and swelling in a woman who is breastfeeding
mastitis
67
standard of care for any patient with a palpable breast mass
mammogram
68
women with extremely dense breasts (level 4) should be alternatively screened using what modalities?
MRI or automated breast ultrasound
69
most common breast lesion in young women who present with breast lumps and pain that gets worse around their period
fibroadenoma
70
patients diagnosed with [...] do not benefit from radiation or lumpectomy
LCIS (tamoxifen alone is sufficient)
71
what muscle is used to guide levels of the axilla for lymph node dissection?
pec minor
72
common anesthesia regimen used for breast cancer cases
propofol, midazolam, and fentanyl
73
resistance to Her2 targeted therapies are often due to
cleavage of Her2 extracellular domain
74
the [...] domain of the Her2 protein is the target of pertuzumab
dimerization domain
75
use of anti-estrogens depends on
scoring the tumor ER positive (any tumor over 1% is considered ER+)
76
targets the intracellular tyrosine kinase activity of Her2
lapatinib
77
blocks Her dimerization through the extracellular domain
trastuzumab
78
mTOR inhibitor
everolimus afinitor
79
mutations within the [...] domain of the estrogen receptor are linked to tamoxifen resistance
ligand binding (Y537 and D538G)
80
palbociclib, abemaciclib, and ribociclib can be used to inhibit [...] in metastatic breast cancer
CDK4/6
81
exemestane is an [...] inhibitor
aromatase
82
combining endocrine therapy with [...] inhibitor in HR+ breast cancers is effective in treating metastatic disease
CDK4/6 (-ciclibs)

RDS Test 3 (15 decks)

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