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Oncology > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What mutation increases the incidence of breast and ovarian cancers?

A

BRCA1

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2
Q

What mutation increases the risk of ovarian cancer in both male and female breast cancer?

A

BRCA2

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3
Q

What genetic mutations have a part in causing breast cancer?

A
  1. p53 mutation
  2. BRCA1
  3. BRCA2
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4
Q

What are risk factors for breast cancer?

A
  1. female
  2. age
  3. genetic mutations
  4. family history
  5. endogenous estrogen exposure
  6. benign breast disease
  7. obesity
  8. low physical activity
  9. alcohol cosumption
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5
Q

Is early menarche <14 years a risk/protective factor?

A

risk

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6
Q

Is late menopause > 55y/o a risk/protective factor?

A

risk

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7
Q

is having your first child younger than 30 y/o a risk or protective factor?

A

protective

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8
Q

How do oral contraceptives effect breast cancer risk?

A

benefits usually outweigh risk

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9
Q

How do HRT effect breast cancer risk?

A

not clear; little benefit

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10
Q

What factors lower the risk of breast cancer?

A
  1. breastfeeding
  2. moderate/ vigorous physical activity
  3. maintaining healthy body weight
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11
Q

When should screening start for women of average risk?

A

talk to your doctor at age 40 to decide if annual or every other year mammography is appropriate

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12
Q

What is used to prevent breast cancer?

A
  1. prophylactic mastectomy
  2. bilateral oophorectomies
  3. Tamoxifen/Raloxifene
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13
Q

When should patients receive breast cancer prevention?

A

high risk only

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14
Q

What are the most common symptoms?

A
  1. painless lump
  2. stabbing/aching pain
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15
Q

What are less common symptoms?

A
  1. nipple tenderness
  2. change in size/shape of breast
  3. erythema, scaling, eczema, swelling
  4. peau d’orange
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16
Q

What are the sites of metastasis?

A

Bone
Liver
Lung
Brain
Skin

17
Q

When is endocrine therapy used in breast cancer?

A

ER+ and/ or PR+

18
Q

When can trastuzumab be used in breast cancer?

A

HER2neu +

19
Q

What does Ki-67 proliferation index indicate?

A

cancer is spreading fast; need chemo

20
Q

What is the most common type of breast cancer?

A

invasive ductal carcinoma

21
Q

What must patients get if they chose to have a lumpectomy?

A

XRT

22
Q

When is neoadjuvant chemo considered in stage 1,2A, and 2B?

A

if the tumor is too large for a lumpectomy

23
Q

What type of surgery is possible in stage 1,2A, and 2B?

A

mastectomy
lumpectomy

24
Q

When is XRT done in stage 1,2A, and 2B?

A

lumpectomy
lymph node involvement

25
Q

What situations in stage 1,2A, and 2B do patients get adjuvant chemo?

A

ANY of the following:
1. ER and PR negative
2. HER2neu positive
3. lymph node involvement

26
Q

What test can be done in stage 1,2A, and 2B to determine the benefits of chemo?

A

Oncotype Dx test

27
Q

AC

A

anthracycline + alkylating agent

28
Q

TC

A

docetaxel + cyclophosphamide

29
Q

TAC

A

docetaxel, doxorubicin, and cyclophosphamide

30
Q

How long does someone get adjuvant chemo in stage 1,2A, and 2B?

A

6 months

31
Q

What should not be given in combination with trastuzumab?

A

anthracycline

32
Q

What are side effects with trastuzumab?

A
  1. cardiac concerns (CHF, MI, decreased LVEF)
33
Q

What is the MOA of Tamoxifen?

A

SERM (selective estrogen receptor modulator); competes with estradiol binding to estrogen receptors

34
Q

What are side effects with Tamoxifen?

A
  1. hot flashes
  2. vaginal dryness/discharge
  3. irregular menses
  4. endometrial thickening
  5. THROMBOEMBOLISM
  6. ENDOMETRIAL/UTERINE CANCER
35
Q

What beneficial effects does tamoxifen have?

A
  1. may prevent bone loss
  2. lowers total cholesterol
36
Q

What 2 psych meds lower Tamoxifen effects?

A

Fluoxetine
Paroxetine

37
Q

What is the MOA of aromatase inhibitors?

A

inhibits aromatase the enzyme which catalyzes the conversion of androgens to estrogens

38
Q

What are side effects with aromatase inhibitors?

A
  1. Osteoporosis
  2. Musculoskeletal pain, arthralgias
39
Q

When is adjuvant chemo not needed?

A

ER+/PR+ AND
Her2neu - AND
no lymph involvement

Oncology (22 decks)

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