Breast Cancer: Introduction

Question 1

How are breast cancers categorized pharmacologically?

Answer 1

By hormone receptor status (ER, PR, HER2/neu)

Question 2

Why is ER/PR status important?

Answer 2

Because if positive hormone receptor modulators can be used in treatment

Question 3

What special treatments can be used for HER2 tumors?

Answer 3

mABs and RTKis

Question 4

What is the prognosis for triple negative tumors?

Answer 4

Triple negative has a very bad prognosis

Question 5

What are some common mutations in breast cancer?

Answer 5

p53
BRCA 1/2 
PIK3CA
GATA 3
MAP3K1

Question 6

What is the role of BRCA 1/2?

Answer 6

They are tumor suppressors involved in cell cycle arrest so that the cell can repair double strand DNA breaks.

Question 7

What are the treatment options for BRCA 1/2 carriers?

Answer 7

1. Prophylactic mastectomy. (90% risk reduction)

2. Chemoprevention with SERMs (only for BRCA 2)

Question 8

When should you test for BRCA mutations?

Answer 8

1. Early onset of breast cancer (<45 yo)
2. Ovarian/fallopian/primary peritoneal cancer
3. 2+ primary breast tumors
4. Male breast cancer
5. Family Hx / Ashkenazi Jews

Question 9

What treatment options are unique to pre-menopausal women?

Answer 9

1. Oophorectomy (stop the estrogen source)

2. GnRH modulators

Question 10

What treatment options are unique to post-menopausal women?

Answer 10

Aromatase inhibitors