Breast Cancer Flashcards by Daniel Allen

Breast cancer is the most common type of cancer globally.

a. true
b. false

a. true

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What typeof gene is p53?

tumor suppressor gene

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The normal BRCA gene helps __ repair

DNA

tumor suppressor gene

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Age >= ___ is a risk factor for breast cancer

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Early menarche at <= __ years old is a risk factor for breast cancer

Endogenous estrogen exposure:

early menarche (<=12)
late menopause (>=55)
late 1st pregnancy (> 30)

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Being HR __ is a poor prognostic factor

a. positive
b. negative

a. positive

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Biomarker testing is a NCCN strong consideration for tumor size > __ cm and risk score determines therapy decisions`

0.5

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__ is highly recommended

a. breast self exam
b. breast self awareness

b. breast self awareness

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Which guideline does not recommend clinical breast exam?

a. ACS
b. USPSTF
c. NCCN

select two

a, b

NCCN:

age 25-39 every 1-3 years
age >=40 annually

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NCCN recommends mammography annually for what age?

> = 40

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___ is used to assess extent of disease

a. ultrasound
b. MRI

b. MRI

assess extent of disease
evaluate abnormalities found on other diagnostic tools

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__ is used for pathology assessment

a. ultrasound
b. MRI
c. biopsy

c. biopsy

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Give chemotherapy in breast cancer with tumors of what size?

> 1cm

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What is general treatment for HR+, LN-, HER2- with RS < 26?

adjuvant endocrine therapy

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What is general treatment for HR+, LN-, HER2- with RS >26

adjuvant endocrine therapy +/- chemo

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What is general treatment for HR+, LN-, HER2+ with T<=0.5 or T 0.6-1cm?

T <=0.5cm: consider adjuvant endocrine therapy +/- chemo + trastuzamab

T 0.6-1cm: adjuvant endocrine therapy +/- chemo +/- trastuzamab

What is general treatment for HR+, LN-, HER2+ with T > 1cm?

adjuvant endocrine therapy + chemo + trastuzamab

What mab is +/- with LN positive?

pertuzumab

Taxanes cause what AE?

peripheral neuropathy

What is the general treatment of choice for stage I or II adjuvant chemotherapy for breast cancer?

taxane +/- anthracycline

doxorubicin +
cyclophosphamide for 4 cycles then weekly paclitaxel for 12 cycles

docetaxel + cyclophosphamide

Which class of endocrine therapy has increased CYP2D6 inhibitor interactions?

a. LHRH agonists
b. SERMs

b. SERMs

3 LHRH agonists:

goserelin
leuprolide
triptorelin

which class of endocrine therapy causes bone loss with long term use?

a. LHRH agonists
b. SERMs

a. LHRH agonists

What is the only LHRH agonist approved for breast cancer?

goserelin

Which aromatase inhibitor is steroidal? a. anastrazole b. letrozole c. exemestane

c. exemestane

Aromatase inhibitors reduce cardiovascular risk a. true b. false

`b. false can cause cardiovascular risk

Tamoxifen can be used for a total of __ years

Which drug class is a category I based recommendation for postmenopausal endocrine Tx?

aromatase inhibitors

HER2 targeted therapy: Which drug is used for EARLY adjuvant/neoadjuvant and metastatic?

pertuzumab

Trastuzamab should be used concomitantly with an anthracycline. a. true b. false

b. false AVOID concomitant use with anthracycline

What route is trastuzamab administered?

IV IV load over 90mins, maintenance over 30 mins

Consider __ for one year after trastuzumab for stage 3 breast cancer

naratinib

Is endocrine therapy given before or after chemotherapy for metastatic breast cancer?

after

Which metastatic breast cancer site responds well to endocrine therapy? a. bone b. visceral c. brain

a. bone

Which drug is used for triple negative breast cancer and PDL1+?

atezolizumab

Which class is given to stop or control endocrine therapy resistance wit HR+, HER2-?

CDK4/6 inhibitor (-ciclib) ``` class effect: neutropenia and fatigue ```

What drug is used for PIK3CA mutation?

alpelisib

What is treatment of choice for resectable breast cancer?

surgery

What is treatment of choice for early stage breast cancer?

anthracycline plus taxane adjuvant chemotherapy