breast cancer Mx Flashcards
surgery - tumour removal
breast conserving surgery
mastectomy
surgery - axillary clearance
majority or all lymph nodes removed
done when cancer cells found in nodes
inc risk of chronic lymphoedema in that arm
Chronic Lymphoedema
impaired lymphatic drainage
can occur in entire arm after breast cancer surgery on that side
areas of lymphoedema are prone to infection
Chronic Lymphoedema - Mx
massage techniques compression bandages physio weight loss good skin care
when is radiotherapy used
patients with breast-conserving surgery to reduce risk occurrence
common radiotherapy side effects
fatigue local skin + tissue irritation fibrosis of breast tissue shrinking of breast tissue long term skin colour changes
how can chemotherapy be usedq
neoadjuvant
adjuvant
treatment of metastatic or recurring breast cancer
hormone treatment
for patients with oestrogen-receptor positive breast cancer
tamoxifen - premenopausal women aromatase inhibitors (e.g. letrozole) - for postmenopausal women
tamoxifen
selective oestrogen receptor modulator
- blocks oestrogen in breast tissue
- stimulates receptors in uterus andbones
helps osteoporosis but inc risk endometrial cancer
aromatase inhibitors e.g. letrozole
block aromatase from creating oestrogens in fat tissue
how long is tamoxifen/aromatase inhibitors given for
5-10yrs
Targeted treatments - trastuzumab (herceptin)
HER2 receptor monoclonal antibody
used in patients with HER2 positive breast cancer
can affect heart - need close monitoring of heart function
Targeted treatments - Pertuzumab (perjeta)
HER2 receptor monoclonal antibody
used in combination with trastuzuman (herceptin)
Targeted treatments - Neratinib
tyrosine kinase inhibitor, reducing growth of breast cancers
may be used in pt with HER2 positive breast cancer
follow up
surveillance mammograms yrly for 5yrs
+ longer if not old enough for regular breast screening programme
