Breast Cancer Management Flashcards
What does HER2 stand for?
Human epidermal growth factor receptor 2
What is the standard of care for a malignant breast lump?
Local excision with sentinel lymph node biopsy
How is cancer treated?
Local treatment - Surgery - Radiotherapy Systemic treatment - Chemotherapy - Hormonal therapy - Targeted therapy Supportive care - Social worker - Dietitian - Physiotherapy - Breast care nurses - Cancer liason nurse
What are the two most active chemotherapy agents in early breast cancer?
Athracyclines
Taxanes
What is the specific treatment if a breast cancer is HER2 positive?
Trastuzumab = Herceptin = mAb targeting HER2
What is a neoadjuvant?
Given before surgery to shrink tumour size
What is tamoxifen?
Selective oestrogen modulator > can be agonistic in some tissues
What do aromatase inhibitors do?
Inhibit conversion of androgens to oestrogen in peripheral tissues
In which patient population are aromatase inhibitors effective?
Post-menopausal women
What needs to be done before aromatase inhibitors can be used in pre-menopausal women?
Have to suppress ovarian production = medical menopause
What are the indications for radiotherapy in breast cancer?
After breast conservation surgery Large primary tumour >5 cm Lymph node involvement 4+ lymph nodes - 1-3 considered in younger patients Involvement of skin and/or muscle Positive surgical margins
What family history is a red flag for breast cancer?
Cancers of breast and ovaries
What genes have been identified to genetically predispose to the development of breast cancer?
BRCA1
BRCA2
What are the important considerations when assessing family history in breast cancer?
Age of diagnosis
Bilateral breast cancer
Breast and ovarian cancer in same person
