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PHRM 864 > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

how common is breast cancer death in women compared to other cancers

A
  1. lung
  2. cancer
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2
Q

are breast cancer cases / deaths going up?

A

no, they have decreased

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3
Q

do most breast cancer pts have risk factors?

A

no, 60%+ do not have risk factors

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4
Q

risk factors for breast cancer (11)

A

increased age
family history
personal history
radiation
early menarche/late menopause
oral contraceptive / HRT
alcohol
breast biopsies
age >30 first birth
elevated BMI
diet (soy protective)

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5
Q

what percentage of breast cancers are familial

A

5-10%

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6
Q

what are the genes that are linked to breast cancer genetics

A

tumor supressors:
BRCA-1
BRCA-2

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7
Q

what is the GAIL risk model

A

RR% of getting breast cancer

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8
Q

invasive types of breast cancer

A

invasive ductal carcinoma
invasive lobular carcinoma

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9
Q

most common type of breast cancer

A

invasive ductal carcinoma (70%)

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10
Q

non-invasive breast cancer types

A

ductal carcinoma in-situ
lobular carcinoma in-situ

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11
Q

inflammatory breast cancer description

A

aggressive form with rapid onset and poor prognosis
days and weeks onset

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12
Q

inflammatory breast cancer symptoms

A

edema
redness
warmth
inflammation
orange peel look

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13
Q

breast cancer most common presentation

A

90% will have painless lump

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14
Q

how many will develop metatstatic

A

50%

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15
Q

what does FISH testing test for

A

HER2

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16
Q

what tests are for HER2

A

FISH and IHC

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17
Q

what is the oncodx

A

determines likelyhood that the cancer will return and if patient would benefit from chemo

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18
Q

what kind of patients can we use oncotype dx on

A

ER+ HER2- newer diagnosis low stage

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19
Q

low risk wouldnt benefit from chemo score

A

under 26

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20
Q

high risk would benefit from chemo score

A

26+

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21
Q

under 50 but score of what means chemo would be beneficial

A

16-25

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22
Q

who mainly gets chemo before surgery

A

Stage IIIB and IIIC

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23
Q

who mainly gets chemo after surgery (Stage)

A

I II IIIA

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24
Q

stage IV surgery?

A

no, only for symptomatic relief

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25
Q

adjuvant means what

A

after surgery

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26
Q

neoadjuvant means what

A

before surgery

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27
Q

radiation comes before or after surgery

A

after

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28
Q

what stages are we trying to cure

A

I, II, III

29
Q

which HER2 patients should get chemo

A

tumor >0.6 cm
HER2 targeted, chemo, hormone

30
Q

HER2+ with tumor <0.5 reccomendation therapy

A

HER2 targeted
+/- chemo
endocrine therapy

31
Q

SERM drug

32
Q

oophrectomy reccomended for who

A

premenopausal women with intact ovaries

33
Q

LNRH analogs reccommended instead of what

A

taking out ovaries

34
Q

LNRH analog drugs

A

leuprolide
goserelin

35
Q

side effect of leuprolide and goserelin

A

FSH and LH surge, hot flashes first 2-4 weeks

36
Q

aromatase inhibitors for pre or post meno

37
Q

aromatase inhibitors side effects

A

hot flashes
osteoporosis
muscle aches and pains

38
Q

aromatase inhibitor drugs

A

anastrazole
letrozole
exemestane

39
Q

premenopausal with intact ovaries hormonal treatment

A

tamoxifen for 5 years THEN 5 more years of tamoxifen or AI if no ovaries

40
Q

premenopausal but ovary supression / ovary out

A

tamoxifen or AI x 5 years then either for 5 more years

41
Q

if postmenopausal at diagnosis whats the ideal treatment

A

AI for 5 years + 5 more years

42
Q

standard chemo length

A

4-6 cycles given every 3-4 weeks

43
Q

most common chemo classes given in breast cancer

A

anthracyclines
taxanes

44
Q

HER2 negative chemo regimens

A

AC w paclitaxel
TC

45
Q

what is AC with paclitaxel consist of

A

doxorubicin
cyclophosphamide
paclitaxel
every 2 weeks with CSFs

46
Q

what is TC consist of and why would we use this

A

docetaxel
cyclophosphamide
if extensive cardiac history

47
Q

what is dose dense

A

same dose shorter interval

48
Q

HER2 negative patient with cardiac tox should do what

A

docetaxel + cyclophosphamide

49
Q

HER2+ patients older treatment

A

APT
paclitaxel
trastuzumab (1 year)

50
Q

HER2+ patients who are younger

A

TCH + P
docetaxel
carboplatin
trastuzumab
pertuzumab

51
Q

how long should pts be on trastuzumab

52
Q

triple negative chemo

A

paclitaxel
carboplatin
pemborlizumab
THEN
doxorubiucin
cyclophosphamide
pembrolizumab

53
Q

how long should pembrolizumab be going for

54
Q

er+ metastatic pts with long disease free survival, chemo or hormone?

A

hormone therapy

55
Q

metastatic pts with short disease free survival agent

A

chemotherapy

56
Q

metastatic HER2+ chemo regimen

A

trastuzumab
pertuzumab
docetaxel / paclitaxel

57
Q

how long to continue trastuzumab and pertuzumab in metastatic disease

A

not a year

58
Q

metastatic second line HER2 low

A

fam-trastuzumab

59
Q

fam-trastuzumab used in who

A

1+ HER2 in metastatic

60
Q

fam-trastuzumab side effect

A

shortness of breath

61
Q

metastatic triple negative treatment

A

platinum
pemborlizumab if 10+ score

62
Q

what do we check if putting someone on CDK4/6 inhibitors

A

CBC monthly

63
Q

which CDK4/6 has QTC prolongations

A

ribociclib

64
Q

which CDK4/6 has diarrhea

A

abemaciclib

65
Q

first and second line treatment in ER+ HER2- metastatic

A
  1. AI + CDK4/6
  2. everolimus + fulvestrant
66
Q

what age should women start thinking about mammograms

67
Q

what age should mammograms be yearly

68
Q

which drugs can be used as preventative in high risk pts

A

tamoxifen
raloxifene

PHRM 864 (28 decks)

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