BREAST Flashcards
With special management doesn’t triple negative breast cancer need
Add Taxol
Management of locally advanced disease Chest wall
XRT
Also use XRT to the axilla if four or more nodes
When do use neoadjuvant
therapy Triple negative
Her2-nu +
Locally advanced
Inflammatory breast cancer
When do you use adjuvant therapy
Greater than 1 cm
Node positive
When you get genetic testing
Breast cancer under the age of 45
What is new adjuvant chemotherapy regimen
Three cycles:
Adriamycin
Cisplatin
With Taxane
Management of breast metastasis to the liver or the long
One isolated met with extremely favorable clinical scenario i.e. no other distant disease
On extensive workout
Consideration given to metastasis resection
Treatment for first trimester breast-cancer
Mastectomy
Breast cancer chemotherapy
TAC
Taxane
Adriamycin
Cis-platinum
Contraindications from normal breast cancer management in pregnancy
No taxane
No methotrexate
No blue dye
No tamoxifen
Management is an 80-year-old with breast cancer
Consider no chemotherapy if life expectancy less than or equal to five years
Significance in screening of breast cancer luminal a
Association with BRCA2?
MRI six months
Mammogram six months
Decreased breast cancer risk with bilateral mastectomy
Decrease cancer risk 95%
Decreased overbearing cancer with bilateral oophrectomy
Decreased cancer risk 80%
Cancer is associated with the BRCA II
MALE breast cancer
prostate!
Melanoma!
Pancreas cancer
ovarian cancer I>II (2 is the male and males do not have ovaries)
Uterine papillary serous carcinoma
Worst prognosis breast cancer
Basal
This is triple negative
(three leaves of the basil plant)
BRCA I is worse then BRCA II
Management of a breast abscess six months postpartum
Aspirate
Antibiotics
Pump infected side
“Medullary” breast cancer
Rapidly enlarges
Due to lymphocytic reaction
Axilla notes are not cancer but still take them out
Tubular carcinoma of the breast
subtype of invasive ductal carcinoma
usually small (about 1 cm or less)
made up of “tubules.”
Breast cancer risk with atypical doctoral hyperplasia
1.6% in 5 five years
20% lifetime
This qualifies risk factor for MRI
What is the risk of developing breast cancer with LCI S
60% DUCTILE carcinoma
40% lobular carcinoma
Margins for a pheloides tumor
Coach says 2 cm
Possibly one centimeter
Drugs that can cause gynecomastia
Spironolactone
Digitalis
Marijuana
Who is not qualified for Z11
Patients undergoing mastectomy
BRCA II
Prostate (Male breast cancer)
Pancreas
Melanoma
Ovaries
Pagets is associated with what breast cancer
Adenocarcinoma
Anal ulcer is treated how if it is found to be squamous cell carcinoma
Niagara protocol
5-FU (because everyone gets 5-FU
mitomycin C
“Mighty mouse is here to save the day if anus cancer”
Coach says 3.5 gray
4.5 gray uptodate
Breast cancer risk factors to ask you about in the history
Agent menarche Age of menopause Pregnancy / breast feeding Estrogen exposure - hormone replacement Birth control pills Radiation exposure Family history History of breast lesion or biopsy
Breast cancer chemotherapy
And modifications for pregnancy
Taxane - NO for pregnancy
Adriamycin (watch the heart with cardiomypathy of pregnacy)
Cis-platinum
Herceptin - NO for pregnancy
Management of recurrent pheloids tumor
Re-excise
neo adjuvant therapy for what breast cancer
Inflammatory
Advanced local disease (greater than 5 cm)
Clinically positive nodes
(possibly for familial)
What is basic Z-11
1-2 nodes positive
T1 (0.1 - 2 cm)
T2 (2.1 - 5 cm)
Already going to get whole breast radiation from lumpectomy
does NOT apply to patients getting a mastectomy
Work up with patient history of breast cancer and increased calcium
Get a phosphorus level with the calcium.
Phosphorus level will be elevated as well if this is an metastatic bone disease
If restaging negative:
Get PTH
