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Medicine, oncology > Breast cancer > Flashcards

Breast cancer Flashcards

1
Q

RFs breast ca?

A 
BRCA1 and 2
Sex
age
reproduction
family history
Post-meno HT
OCPs
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2
Q

Prognostic factors?

A 
LYMPH NODE INVOLVEMENT
Size
histo
grading
margins
vessel invasion
HER2, ER
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3
Q

Predictive factors?

A

Her 2 overexpression

ER and PrG expression

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4
Q

Which carcinomas in situ?

A

Ductal DCIS

Lobular DCIS

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5
Q

Which carcinoma in situ is often multifocal?

A

Lobular DCIS

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6
Q

Which breast ca does not have invasion of basement membrane?

A

Ductal DCIS

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7
Q

Which infiltrating cancers are there?

A

Ductal and lobular

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8
Q

Which breast ca is MC?

A

Infiltrative ductal

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9
Q

Which breast ca type is Paget’s disease?

A

Infiltrative Ductal

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10
Q

Where in breast is ca usually?

A

Upper outer quadrant

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11
Q

When to start mammography?

A

40 years old, once a year

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12
Q

How to diagnose breast ca?

A

Mammogram –> microcalcifications ==> BIOPSY!

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13
Q

Which tumor markers in breast ca?

A

NO TM

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14
Q

Where is metastasis MC?

A

Bone
Lung
Liver
Brain

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15
Q

Which surgical tx?

A

TUmorectomy
Breast conserving tx
Total mastectomy (Patey’s operation)

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16
Q

What is done in BC tx?

A

Remove tumor and sentinel lymph node

RADIOTHERAPY

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17
Q

How to find sentinel l n?

A

Blue dye

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18
Q

When is breast conserving tx contraindicate?

A 
Tumor > 5 cm
too large tumor in ratio to breast
Previously irradiation-tx
retroareolar
Positive margins
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19
Q

Define T4A

A

Spread to chest wall

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20
Q

Define T4B

A

Spread to skin, swollen

21
Q

Define N3

A

Spread to collarbone, behind sternum

22
Q

Which classification is used to choose tx?

A

St. Galleon Consensus

23
Q

What is Ki-67?

A

Cellular marker for proliferation

24
Q

Which classes in St Galleon?

A

Luminal A
Luminal B
HER2+
Triple Negative

25
Q

Which class har best prognosis?

A

Luminal A

26
Q

Characteristics of Luminal A?

A

ER+ and PgR+
HER 2 -
Low Ki-67

27
Q

Tx of Luminal A?

A

ONLY hormonal

28
Q

Characteristics of Luminal B?

A

Divided into HER2 neg and positive:

HER2- : ER+, PgR+, HER2-, HIGH Ki 67

HER2+: ER+, PgR+, HER2+, ANY Ki-67

29
Q

Tx in Luminal B?

A

HER2 neg: Hormonal and Cytotoxic therapy

HER2 positive: Hormonal, Anti-HER2 and cytotoxic tc

30
Q

What defines LUMINAL classes?

A

ER and PgR POSITIVE

31
Q

Which classes are ER and PgR NEGATIVE?

A

HER2 +

Triple Negative

32
Q

Characteristics of HER2 positive?

A

HER2 overexpressed

ABSENT ER and PgR

33
Q

Tx of HER2 positive?

A

CYtotoxic and anti-HER2 tx

34
Q

Characteristics of Triple Negative?

A

HER2 NEGATIVE

AVSENT ER and PgR

35
Q

Tx of Triple Negative?

A

ONLY cytotoxic

36
Q

Which class has poorest prognosis?

A

Triple negative

37
Q

Can you give Anti-HER2 tx without chemotx?

A

NO!!

38
Q

When is neoadjuvant tx given?

A

Locally advanced tumors T3, N2+

(Stage III)

39
Q

Which chemotx?

A

Doxorubicin
Docetaxel
Cyclophosphamide
5 FU

40
Q

Tx given in ER+ pt?

A

TAMOXIFEN
LHRHA
Aromatase inhibitors

41
Q

When is adjuvant HORMONAL tx given?

A

in all who show presence of ANY detectable estrogen receptors

42
Q

Which hormonal adjuvant tx to premenopausal?

A

Tamoxifen

GnRHA antagonist

43
Q

Which hormonal adjuvant tx to postmenopausal?

A

Tamoxifen

Aromatase inhibitors

44
Q

Side effects of Tamoxifen?

A

Endometrial cancer!!!

Thromboemboli

45
Q

Side effects of aromatase inhibitors?

A

Bone fractures!

46
Q

Which tx if HER2 +?

A

Trastuzumab (Herceptin)

47
Q

How long to give trastuzumab?

A

1 YEAR

48
Q

Side effects of trastuzumab?

A

Cardiotoxicity

49
Q

Follow up after tx?

A

Every 3 months first 3 years

–> every6-12 months

Medicine, oncology (15 decks)

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