Breast Cancer Flashcards
at what age are we beginning to screen for breast ca with a mammogram?
40
what puts someone at high risk for breast ca and when do we screen these pt?
family hx; 10 years b4 they were dx… other RF’s family hx of pancreatic ca, Ashkenazi jewish background
What other screening modalities are u going to consider for a women with denser breast tissue that makes mammograms less sensitive
US or MRI
when do we consider performing stereotactic bx
microcalcifications on US
how does the US help us evaluate a mass?
whether or not its cystic vs. solid
What do you do if you find a breast cyst that measures >2cm on U/S
stick a needle in it to aspirate…
When do you want to consider surgically excising a fibroadenoma?
If it is complex
Adjacent proliferative Dz
Family Hx of breast Ca
How will u tx a pt who u suspect has phyllodes tumor characterized as a very large aggressive FA
excise
Who is at increased risk for non-lactational breast abscess
smokers, obese, diabetics
how do u w/u a breast abscess
U/S Not mammogram
What charecteristics to the breast abscess would raise ur suspicion for anaerobic pathogen? What would u add to the abx regimen which should already cover for staph aureas.
- subareolar abscess
- retracted nipple
Add Flagyl
which colors of nipple dx are usually benign? Concerning?
milky/green-benign
clear/bloody-concerning
How do u tx ductal carcinoma in situ
endocrine tx alone (no chemo) if at stage 0
when do u check axillary lymph nodes (sentinel nodes) for DCIS
when it’s high grade, lateral or large lesions, mastectomy
What is the breakdown in % of types invasive breast ca?
80% ductal
10% lobule
other 10%-
Favorable-intracystic, papillary, mucinous, tubular, medullary
Unfavorable-metaplastic, and angiosarcoma
what is an angiosarcoma
post-radiation tumor (unfavorable)
This dz involves skin lesion of the nipple, is associated w/ DCIS
Paget’s dz
IF you discover ur pt is Her2neu positive, what pharm. intervention could u imploy
Herceptin (trastuzamab) which is a monoclonal antibody
How do we use molecular profiles via recurrence risk score to treat breast ca?
If low-endocrine therapy only
If High=add chemo
Intermediate-consider chemo
Differentiate the two types of radiation for breast ca
External Beam- 4-6wks M-F
Brachytherapy: smaller lesions, neg. nodes, older age
Define the TNM stages for breast ca
TX-not known T0 T 5 stage 3 Nodes: # involved Mets- stage 4 (skin involvement)
what are F/U for lumpectomy vs. mastectomy
lumpectomy require mammogram q 6 months for 2 yrs. whereas no regular imaging required for mastectomy
