breast cancer

Question 1

symptoms of metastatic breast cancer

Answer 1

bone (eg, back or leg pain), liver (abdominal pain, nausea, jaundice), and lungs (eg, shortness of breath or cough)

Question 2

how to differentiate malignant vs. benign mass

Answer 2

US

Question 3

most common type of invasive breast cancer

Answer 3

infiltrating ductal carcinoma

Question 4

mammogram is…

Answer 4

x-ray

Question 5

USPSTF mammography recommendation

Answer 5

every 2 years after age of 50

Question 6

what does DCIS mean?

Answer 6

group of precancerous lesion confined to breast ducts and lobules

Question 7

microinvasive breast cancer

Answer 7

DCIS w/ microinvasion. associated with high-grade DCIS.

Question 8

cancer workflow

Answer 8

ddx –> determine hormone receptor status –> surgery –> staging –>

Question 9

prognostic factors

Answer 9

• receptor positivity

- lymph node involvement

Question 10

abnormal imaging finding followed by…

Answer 10

stereotactic biopsy, US, or MRI

Question 11

breast mass workup…

Answer 11

FNA or core needle biopsy –> biopsy positive then axillary node dissection, biopsy negative sentinel lymph node biopsy.
ALSO if negative axillary examination clinically then sentinel lymph node biopsy.

Question 12

signs of inflammatory breast cancer then…

Answer 12

full-thickness skin biopsy

Question 13

Stage IA…

Answer 13

T1, N0, M0

Question 14

Stage IB…

Answer 14

T0/1, N1, M0

Question 15

Stage IV means

Answer 15

distant mets

Question 16

Stage II means

Answer 16

basically N2

Question 17

early stage stages

Answer 17

I, IIA, or subset of IIB

Question 18

locally advanced stages

Answer 18

IIIA to IIIC

Question 19

treatment of early-stage breast cancer

Answer 19

local treatment with –> lumpectomy or mastectomy with or without radiation therapy
THEN –> adjuvant systemic therapy based on ER/PR/HER2

Question 20

breast-conserving therapy (BCTT)

Answer 20

lumpectomy + radiation therapy

Question 21

when RT is indicated post mastectomy..

Answer 21

patients at high risk for local recurrence (cancer involves deep margins and axillary lymph nodes)

Question 22

endocrine therapy used for…

Answer 22

hormone receptor-positive patients

Question 23

chemotherapy used for…

Answer 23

1) early-stage hormone receptor-positive cancers with high-risk characteristics
2) non hormone receptor positive for tumor size greater than 0.5 cm

Question 24

mgmt of locally advanced breast cancer

Answer 24

neoadjuvant systemic therapy before surgery

Question 25

BCT vs. mastectomy depends on…

Answer 25

• breast size in relation to residual tumor size

- large breast lesion then mastectomy

Question 26

mgmt of HER2-positive breast cancer

Answer 26

1 yr of trastuzumab following completion of surgery

Question 27

after mastectomy then…

Answer 27

RT, but depends on pretreatment stage

Question 28

people with hormone receptor negative, HER2 negative breast cancer get…

Answer 28

chemo

Question 29

For patients with hormone receptor-negative, HER2-positive metastatic breast cancer, we recommend…

Answer 29

HER2-directed therapy in combination with chemotherapy.

Question 30

For patients with hormone receptor-positive, HER2-negative breast cancer, we recommend…

Answer 30

endocrine therapy. no evidence for concomitant use of chemo