Cancer Diagnostics Flashcards
procedure that is performed to detect the presence of a specific disease in an asymptomatic person
screening (looks for the presence of cancer in population of healthy persons or asymptomatic)
process of identifying a disease based on its signs and symptoms, PE, and results of diagnostic/ancillary procedures
diagnosis, for the confirmation of a clinical suspicion of cancer
description of the extent of spread of the cancer
staging
monitoring the response to treatment/progress of disease/cancer recurrence
surveillance
t/f diagnostics isn’t important if patients choose to stop treatment or choose supportive care
false, still important to determine status of cancer
imaging modality that reduced mortality from breast cancer
mammography
most common requested radiographic imaging
cxr
- does not provide definitive diagnosis of lung ca at an early stage
t/f the presence of effusion can confirm cancer
false, both infection and cancer can cause effusion
purpose of ct scan
- can be use to guide interventional procedures (biopsy, drainage, targeted rad)
screening test for lung cancer
low dose computed ct scan, reduction of 15-20% in lung ca mortality
indications for low dose computed ct scan
- age 55-74
- more/= 30 pack year smoking history
- still smoking or have quit within the past 15 years
breast ca on mammogram can appear as __
masses, area of asymmetry, malignant calcifications, architectural distortions
birads category
0 incomplete 1 normal 2 benign 3 indeterminate 4 suspicious for malignancy 5 malignancy
mammogram screening recommendations
USPSTF: 40-49 yo individualized, 50-74 yo every 2 years
ACS: 40-44 yo annual, 45-54 annual
NCCN: more/= 40 yo annual
types of ultrasounds
- breast
- abdominal: liver, gb, spleen, pancreas, kidneys, urinary bladder, ascites
- transvaginal/pelvic
- endoscopic: esophageal, pancreatic, rectal
benign breast lesions on uts
simple cysts: circumscribed anechoic mass with thin imperceptible wall
complicated cysts: hypoechoic with no discernable doppler flow, internal echoes, indistinct margins
benign mass: oval or ellipsoid, wider than tall, circumscribed margins, smooth
malignant breast lesions on uts
spiculatioins, angular margins, marked hypoechogenicity, post acoustic shadowing, microcalcificaitons, ductal ext, branching patterns, microlobulations
taller than wide and skin thickening
principle of radionuclide imaging
- application of radioactive substance taken internally -> external detectors capture and form images from the radiation emitted by the radiopharmaceuticals
types of radionuclide imaging and pharmaceutical
bone: tc-99m with mdp
thyroid: i-131
ocreotide: iridium 111 pentetreotide
pet scan: flurodeoxyglucose
t/f when a pet scan detects uptake of fdg tracer, it’s definite cancer
false, it might be cancer but not definite
t/f in bone scan, more radioactive turnover = more radioactive material
true
uses for fiberoptic bronchoscopy
- evaluate centrally located tumors
- assess the extent of airway obstruction
- collect tissue sample for analysis
uses for upper endoscopy (esophagogastroduodenoscopy)
- investigate s/sx of gi
- diagnose and biopsy
- treatment for obstructions caused by tumors (stent for biliary tract or esophagus, clipping polyp)
- screening test for high risk ugi neoplastic process
uses of colonoscopy
- screening test for crc in asymptomatic average risk individuals beginning age 50
- endoscopic polypectomy: remove polyps via wire loop
uses for ercp
- pancreatobiliary disorders
- both endoscopy and fluoroscopy of duodenum and ampulla of vater
- therapeutic: stent insertion to relieve jaundice and pruritus
type of biopsy where tissue is obtained by application of suction through needle attached to syringe
aspiration biopsy
biopsy where inverted cone of tissue is excised as from the uterine cervix
cone biopsy
biopsy where removal of tissue through endoscope
endoscopic biopsy
tissue is removed by surgical cutting
excisional biopsy
circular blade is used and rotated through the epidermis and dermis and into subcutaneous fat
punch biopsy
biopsy of a skin lesion in which the sample is excised using a cut parallel to the surface of surrounding skin
shave biopsy
large hollow needle is used to extract a core of tissue
core needle biopsy (preferred when cancer is suspected because it removes more tissue than fnab and doesnt require surgery)
ihc stains and cancer equivalents
ttf1: lung cd-117: gi stromal tumor cytokeratin: epithelial origin lca (leukocyte common antigen): lymphoma estrogen receptor or progesterone receptor: breast
use of biomarkers or tumor markers
- treatment response
- not specific enough to permit a diagnosis of malignancy
targeted treatments for breast cancer
her2 neu: trstuzumab, pertuzumab, tdm-1, lapatinib
hormone: tamoxifen, aromatase inhibitors
targeted treatments for gastric ca
her2 neu: trastuzumab
targeted treatments for stage 4 colon ca
kras wild type: cetuximab and panitumumab
targeted treatments for gist
exon 9 and 11: imatinib and suntinib
targeted treatments for lung ca
egfr: tkis (geftitinib, erlotinib, afatinib, osimertinib)
alk: crizotinib
pdl1: immunotherapy (pembrolizumab, atezolizumab)
