Breast-Management Flashcards
1
Q
what are the 3 areas you should target for treatment of breast cancer?
A
- breast
- axilla
- micro-metastases
2
Q
what are the treatment options for the breast?
A
- surgery- 2 main types
- Breast conservation surgery
- remove tumour and 1mm healthy breast tissue
- Mastectomy
- removal of breast
- Breast conservation surgery
3
Q
patients suitable for Breast conservation surgery ?
A
- tumour <4cm
- single tumour
- suitable for radiotherapy
- ratio of size of tumour / breast
4
Q
what is the Sentinel Lymph node?
A
1st node to receive drainage from axilla and hence 1st node to which tumour spreads
5
Q
before you decide treatment options for axilla, what should you do?
A
Do Sentinel Lymph Node Biopsy
- if SN is negative for tumour–> other lymph nodes will be too so no further treatment required
- if SN is positive:
- surgical removal of all the lymph nodes in axilla or
- radiotherapy to ALL nodes in axilla
6
Q
complications of treatment to axilla?
A
- lymphedema
- neurovascular damage
- sensory disturbance
7
Q
how can you treat micro-metastases?
A
- hormonal therapy
- chemotherapy
- Targeted therapy ie HER-2
8
Q
- when can hormone therapy be given
- how does it work
- treatment options
A
- can only be given if ER/PR present on tumour
- Tamoxifen stops oestrogen causing tumour cell growth
- if pre-menopausal woman
- Tamoxifen for 5 years
- if post-menopausal woman
- with good prognosis - Tamoxifen for 5 years
- with poor prognosis- Aromatase Inhibitor for 5-10years
9
Q
when can chemotherapy be given?
A
- ideally in <50y/o
- can be given in nodal / grade 3 disease
10
Q
what is HER-2 and in what patients is it given?
A
- monoclonal antibody against HER-2 receptor
- given to patients with overexpression of HER-2 PLUS Chemo
11
Q
what is the follow-up of breast cancer?
A
- clinical examination every 6 months for 3-5 years
- mammogram once yearly for 10 years
