Breast Cancer Oncology Flashcards
who do you give radiotherapy to?
All patients being treated conservatively (wide local excision/lumpectomy
Mastectomy patients selectively
large tumour
extensive nodal involvement (e.g. 4 or above)
involved margins (< 1mm)
Postoperatively to
breast/chest wall
nodal areas: axilla, supraclavicular fossa
Palliatively to painful bony metastases, skin deposits, brain metastases
what are the acute and late side effects of radiotherapy?
Acute:
Skin erythema to moist desquamation
Tiredness
Possible mild dysphagia if irradiating supraclavicular fossa
Late:
Local fibrosis and telangectasia
Lung fibrosis (rarely symptomatic)
Cardiac damage (ischaemic heart disease) – rarer now treatment better ‘planned’
by how much does post op radiotherapy reduce the risk of local recurrence?
by about two thirds
what are the side effects of hormonal therapy?
Infertility
Menopausal symptoms
Weight gain
Endometrial cancer
Deep venous thrombosis
what are the side effects of chemotherapy?
Nausea & vomiting
Infertility
Alopecia
Neutropenia (leading to sepsis)
Mouth ulcers
Lassitude
what as the median survival rate of mets at 2 years
how percentage make it to 5 years?
Median survival with mets: 2 years (20% at 5 yrs.)
where are the most common site for mets?
Brain
Bone
Liver
Lung
how do you treat bone mets?
local radiotherapy
pinning (if suitable)
bisphosphonates
what treatment would you give for HER2 +ve patients
Trastuzumab
when is chemo preffered to hormonal therapy?
when there are liver metastases or lymphangitis carcinomatosa
gives more rapid action
Name chemotherapy agents
anthracyclines, taxanes, capecitabine
What is the absolute benefit in survival of adjuvant chemotherapy in breast cancer?
between 0 and 15%
What is the major difference between aromatase inhibitors and tamoxifen?
AIs lower circulating oestrogen in post-menopausal women; tamoxifen is partial agonist at receptor
What is the benefit of neo-adjuvant chemotherapy in breast cancer?
reduces the number of people who need mastectomy
