Cancer Cases - Barsky

Question 1

Why can’t DCIS cause mets?

Answer 1

No blood vessels or lymphatics on the epithelial side of the duct

Question 2

T/F: microcalcifications are helpful markers during screening mammograms

Answer 2

true; its what radiologists use to be suspicious of DCIS

Question 3

DCIS threatens the (blank) while invasive cancer threatens (blank)

Answer 3

breast, life

Question 4

Genetic changes alter the (structure/expression) of genes while epigenetic changes alter the (structure/expression)

Answer 4

structure, expression

Question 5

T/F: there is no difference in genome structure or gene expression between DCIS and invasive cancer

Answer 5

true; changes in the microenvironment cause one or the other

Question 6

How can you have lymph node mets without lymphovascular invasion?

Answer 6

Cancer has already made it to the lymph nodes and is no longer actively traveling in the lymph vessels

Question 7

What are the two reasons that advanced stage cancer is worse for prognosis?

Answer 7

1. increased tumor burden

2. increased chance of tumor heterogeneity from increased tumor burden

Question 8

T/F: anyone with invasive cancer is at risk for distant mets

Answer 8

ture

Question 9

What is adjuvant and neoadjuvant chemo?

Answer 9

Adjuvant: given immediately after surgery as the main course of treatment
Neoadjuvant: given before surgery to lower the tumor burden

Question 10

What easy test (non-imaging) can you do to determine the likelihood of distant mets?

Answer 10

Blood draw and check for CTCs

Question 11

What is the function of radiation post lumpectomy?

Answer 11

To clear the surgical margins and prevent LOCAL recurrence; chemo prevents systemic recurrence