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Onc Boards > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What is the magic number for “high risk” in the Gail Model

A

> 1.66 yearly risk

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2
Q

6 breast cancer predisposition syndromes

A 
BRCA mutation
Li-Fraumeni
Cowden's (PTEN)
Peutz-Jeghers (STK11 mutation)
CDH1 mutation (lobular breast cancer)
PALB2
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3
Q

Approved medication(s) for breast cancer prevention in premenopausal women

A

Tamoxifen

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4
Q

Approved Medications for breast cancer prevention in Post menopausal women

A

Tam
Raloxifene
Exemestane
Anastrazole

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5
Q

Recommended Breast cancer Screening rec for BRCA mutants or first degree relatives with BRCA mutants as long as life time breast cancer risk is 20-25% based on BRCAPRO

A

MRI starting annually at age 25

Mammo starting at age 30

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6
Q

What stage does pre-op staging become indicated without symptoms in breast cancer?

A

T3N1 (IIIa)-> CT chest/abd/pelvis and Bone Scan

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7
Q

Margin needed for DCIS

A

2 mm

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8
Q

Who needs adjuvant Tam in DCIS? (3)

A

ER+
Premenopausal
2 breasts at risk

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9
Q

Absolute contraindications to breast conserving therapy (6)

A
  • Pregnancy that can’t be completed in tim efor RT
  • Diffuse calcifications on mammogram
  • Multifocal disease not amenable to removal with single incision
  • Grossly pos margins
  • Inflammatory breast cancer(regardless of response to NACT)
  • Homozygous ATM mutation
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10
Q

Who can omit RT after BCT? (4)

A

Age >/=70
Tumor <2 cm
Clinically node negative
ER+ and able to take endocrine therapy

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11
Q

indications for post-mastectomy radiation (3)

A

Tumor > 5 cm
Tumor <5 cm and close margins
Positive axillary LNs

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12
Q

Which ER pos groups need adjuvant Chemo?

A

Postmenopausal-> RS >25, LN +/-

Premenopausal-> Node +, Node - with RS >25

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13
Q

What is adjuvant treatment for Stage I (T1b-c, N0) Her2+ breast cancer

A

12 weeks fo TH with 1 year of total Trastuzumab

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14
Q

What is adjuvant therapy for Her2+ disease who gets path CR following NACT?

A

H or HP x 1 year

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15
Q

1st line treatment for de novo ER+ MBC

A

AI + CDKi

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16
Q

2nd Line treatment for ER+ MBC

A

Fulvestrant + Palbo or Ribo or Abema

17
Q

Only CDK4/6i with approval for monotherapy after ET and CT

A

Abemaciclib

18
Q

CDK4/6i with CNS penetration

A

Abema

19
Q

CDK4/6i with least cytopenias

A

Abema

20
Q

CDK4/6i with most nausea/Diarrhea

A

abema

21
Q

CDK4/6i with QTc Prolongation

A

Ribociclib

22
Q

Approved in 2nd line HR+ MBC with PIK3CA mutation

A

Fulvestrant + Alpelisib

23
Q

What are the dose limiting toxicities for TDM1

A

Thrombocytopenia

LFT elevation

24
Q

Her2 +-> IHC 2+ -> Positive if:

    • Her2/CEP17 ratio >/=_______ and any copy #
    • Her2/CEP17 ratio < ____ and copy # >/= ______
A
    • Her2/CEP17 ratio >/= 2 and any copy #

- - Her2/CEP17 ratio < 2 and copy # >/= 6

25
Q

Which PARPi are approved in breast cancer?

A

gBRCA mutants only

Olaparib and Talazoparib

26
Q

CPS cutoff for pembro + chemo in breast cancer

A

CPS >/=10

27
Q

Pregnancy associated breast cancer typically present with which biomarkers?

A

TNBC.

30% are Her2 pos

28
Q

Scans not to do on preggos (3)

A

Breast MRI
Bone Scan
CT scans

29
Q

What kind of SLN identification technique do you use with preggos

A

No Isosulfan blue dye

30
Q

Which chemo combination has most data in pregnant population

A

AC or FAC

31
Q

What is the complication associated with trastuzumab in pregnancy?

A

oligohydramnios

32
Q

What is recommended wait time for consideration of pregnancy after breast cancer? Any increase in mortality?

A

2 years

No

33
Q

What kind of surgery is needed for Phyllodes tumor

A

Wide excision without axillary staging or adjuvant treatment

34
Q

What biomarker profile does metaplastic breast cancer usually have?

A

TNBC

Onc Boards (6 decks)

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