Breast Oncology and Palliative Care Flashcards

1
Q

what does neo-adjuvant treatment mean?

A

treatment given pre-surgery eg chemo/radio

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2
Q

what kind of patients would get neo-adjuvant hormonal therapy?

A

ER+ patients

less fit patients

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3
Q

material is stained with what substance after FNA?

A

H + E

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4
Q

what neo-adjuvant therapy has a cosmetic advantage and why?

A

chemo, can shrink tumour significantly so that less surgery is needed

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5
Q

what patients would be unsuitable for neoadjuvant chemo?

A

patients with lots of comorbidities

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6
Q

how is hormonal therapy given as an adjuvant therapy?

A

tamoxifen for 5yrs

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7
Q

what aromatase inhibitors are given to patients who have undergone the menopause?

A

letrozole

anastrozole

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8
Q

side effects of hormonal therapy?

A

vaginal dryness

hot flushes

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9
Q

how are side effects of hormonal therapy managed?

A

clonidine

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10
Q

what chemotherapy drugs are given as adjuvant for breast cancer?

A

toxic anthracycline

taxane

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11
Q

side effects of chemo?

A
anorexia
malaise
neutropenia
alopecia
myalgia
peripheral neuropathy
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12
Q

when would you admit someone with side effects from chemo?

A

if fever from neutropaenia

significantly ill

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13
Q

what is trastuzomab?

A

a monoclonal antibody (used in HER2+ patients)

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14
Q

side effects of trastuzomab/herceptin?

A

allergy

reversible heart failure

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15
Q

how are patients with breast cancer followed up after treatment?

A

1 mammogram a year for 3 yrs

back to usual screening after that

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16
Q

palliative Tx of breast cancer?

A

systemic ER blockade with hormonal therapy OR chemo
radiotherapy to breast or to bone mets
bisphoponates for bone mets

17
Q

Tx bone mets

A
ibandronic acid (A bisphosphonate)
radiotherapy
18
Q

Ix bone pain in someone with a PMH of breast cancer

A

CT or bone scan

19
Q

when cannulating what should you be wary of in someone with lymphoedema?

A

dont cannulate ipsilateral arm

20
Q

new lump presents post breast cancer surgery….

A

might be fat necrosis

21
Q

when is checking tumour markers useful in breast cancer?

A

for mets only (not original diagnosis)

22
Q

red flag symptom for bone mets? why?

A

back pain

from spinal cord compression

23
Q

what medication cannot be given with tamoxifen?

A

paroxetine (SSRI)

24
Q

HER2+ breast cancer metastasises where?

A

brain
lung
meninges
pleura

25
Q

lobular breast cancer metastasises where?

A

lung
pleura
peritoneum
gut