Breast cancer oncology Flashcards
What are the oncological treatment options for breast cancer
Radiotherapy
Chemotherapy
Hormonal therapy
Antibodies
define neo-adjuvant
treatment given before surgery
usually to reduce tumour size and make surgery easier
define adjuvant
treatment given alongside surgery, just after
Radiotherapy is an option for neo-adjuvant treatment, true or false
FALSE
chemo and hormonal therapy are options
what are options of adjuvant therapy
radiotherapy - after breast conservation therapy
hormonal therapy
chemotherapy
antibodies - trastuzumab/herceptin
give examples of hormonal therapy
SERMs - tamoxifen
Aromatase inhibitors - letrozole
what are risks of tamoxifen
DVT PE endometrial hyperplasia, polyps endometrial cancer PV bleeding
what are risks of AIs
osteoporosis
which group can AIs only be given to
post menopausal
what kinds of chemo can be given
anthracycline + taxanes
what injection can be given to stimulate bone marrow after depletion from chemo
GCSF
what are side effects of breast chemotherapy
anorexia alopecia peripheral neuropathy myalgia neutropaenia malaise
how is trastuzumab administered and what are its side effects
SC injection
cardiac failure
allergic reactions
what monitoring is needed with herceptin
cardiac monitoring
neo-adjuvant chemotherapy has survival advantage, true or false
false
it is used as it gives better cosmetic outcome
after discharge from oncology what is the follow up
seen by surgeon after 1 year
yearly mammograms for 3 years
list palliative treatment options
systemic treatment for widespread disease
radiotherapy for fungating breast disease or bone mets
bisphosphonates
what could bone pain be a sign of
bone metastases
what 3 factors can be used to estimate the likelihood of recurrence
tumour grade
size of tumour
number of axillary nodes involved
if a breast cancer patient on treatment is septic or has a high fever what is it a sign of and what should be done
neutropaenia
ASAP admission to oncology
what are a side effect of tamoxifen/AIs
hot flushes
if someone has breast cancer and has a mirena coil, what should be done
breast cancer is a contraindication to mirena coil therefore it should be removed
tumour markers are essential in diagnosing breast cancer, true or false
false, they are rubbish for diagnosis and alright for monitoring
list breast cancer tumour markers
CEA
CA15-3
when are tumour markers for breast cancer used
when there is metastatic disease
indications for bisphosphonates
bone metastases
alongside aromatase inhibitors
what should be checked/done before starting bisphosphonates
dental work
in a post menopausal woman with endometrial hyperplasia (or other side effects), tamoxifen should be switched to __
AI eg letrozole
in a pre menopausal woman with endometrial hyperplasia (or other side effects), tamoxifen should be switched to __
GnRH agonist eg goserilin
in radiotherapy, the bigger the size of breast, the greater/lower the reaction
greater side effects
management of lymphoedema in the arm
sleeves and skincare early on
avoid BP readings, cannulation etc of that arm!
what is a new lump after surgery/radiotherapy likely to be
fat necrosis from trauma
what could back pain be a sign of
malignant spinal cord compression
signs + symptoms of spinal cord compression
severe back pain
difficulty walking
radicular pain
management of spinal cord compression
urgent MRI
radiotherapy
which group of drugs interact with tamoxifen
antidepressants
which hormone receptor + type of breast cancer has the higher rate of recurrence
HER2 +
in addition to the “normal” areas of metastases, where can HER2 + tumours additionally spread to
CNS - brain + meninges
Pleura
Retina
what could be the cause of a low grade headache in a HER2+ patient
CNS metastases
what could be the cause of blurry vision in a HER2+ patient
retinal metastases
which type of breast cancer is often missed on imaging
lobular
lobular carcinoma is easy/difficult to identify on mammogram
difficult
in addition to the “normal” areas of metastases, where can lobular carcinomas additionally spread to
and how can patients present
gut and peritoneum
subacute bowel obstruction
how can you reduce your risk of developing breast cancer
healthy BMI + exercise
self screening
no excessive alcohol intake
