Breast Neoplasm- Ulas

Question 1

What is the most common mortality and morbidity in female?

Answer 1

Breast ca

Question 2

Ca is treatable…

Answer 2

When caught early on with screening

Question 3

Risk factors of breast ca?

Answer 3

Non-modifiable risks: family Hx, genetics, gender, age

Related to lifestyle(modifiably): pregnancy, oral contracptives, obesity, alcohol, hormone replacement therapy, exercise)

Controversial risks: fatty diet, abortion, breast implants, estrogen metabolism, smoking

Question 4

Does breast radiotherapy cause ca risk?

Answer 4

Yes 9%

Question 5

Does MMG (mamography) have risk of ca if done once a yr?

Answer 5

None

Question 6

**What are the imp principles for early diagnosis of breast ca?

Answer 6

Mammorgraphy

Clinical breast exam

Breast self examination

Question 7

When should screening be done for women over 40 w/ no complaints

Answer 7

Annually MMg is enough

Question 8

When should screening be done for history of breast cancer before the age 50 yrs in the family?

Answer 8

10 years before the occurrence

Not before 25 years

Question 9

When should screening be done for wome with high risk?

Answer 9

Strong Family History
Over 15-20% risk of lifelong Breast cancer Can start at 25
MRI can be preferred

Question 10

Q, which stage of TNM is compliant with the following treatment*?

Question 11

What are the definite contraindications breast preserving surgery?(the reasons you shouldn’t preserve the breast)

Answer 11

[M.I.MC.DC.SMN.TD.RT]
1-patient’s request for mastectomy
2-inflammatory type breast cancer
3-presence of multi-centric tumor
4-Diffuse calcifications of breast
5-Failure to achieve surgical margin negativity
6-inappropriate tumor diameter
7-presence of contraindications for RT(radiation therapy)

Question 12

*What is the gold standart dx for breast cancer?

Answer 12

Sentinel lymph node biopsy

Question 13

What is the tx in lobular carcinoma in situ [premalignant lesion] (stage0)?

Answer 13

-Tamoxifen(anti-estrogen) (—>loss of fertility)

-close monitering

-Prophylactic mastectomy

Question 14

What is the tx in ductal carcinoma in situ[premalignant lesion] (stage0)?

Answer 14

-excision with clean surgical margins(>2mm)

-Mastectomy

-Tamoxifen (anti-estrogen) after surgery

-Sentinel lymph node biopsy; for pt with solid comedo necrosis

Question 15

When do you perform chemotherapy?

Answer 15

> 1cm Hormone receptor (+) breast cancer
0.5cm HR (-) breast cancer

Question 16

What are the drugs used for HER-2 receptor + diseases that can increase survival rate?

Answer 16

Trastuzumab

Pertuzumab

Lapatinip

Question 17

What is the tx for stage 3 breast cancer?

Answer 17

Neoadjuvant therapy is primarily considered:

– HR (-), CT in HER-2 (+) patients

– HR (+) endocrine therapy

Question 18

Which method is sensitive in nodal assessment in breast cancer?

Answer 18

Sentinel lymph node biopsy

Question 19

Stage 4 tx for HR+ breast cancer pt?

Answer 19

Endocrine therapy