cancer Part 5 Flashcards
What is the most prevalent cancer in women in the western world?
Breast cancer
What is the driver for breast cancer?
Oestrogen exposure
TNM system is used in Breast cancer. True/false?
True
Describe breast cancer
Breast cancers usually are epithelial tumours of ductal or lobular origin
List the various classifications of breast cancer
Ductal carcinoma in situ( DCIS)
Lobular carcinoma in situ
Invasive ductal carcinoma (ductal breast cancer)
Invasive lobular carcinoma
medullary carcinoma
Inflammatory BC
Mammary Paget disease
tubular carcinoma
Papillary carcinoma
what is the biggest risk factor in breast cancer?
Age
Familial breast cancer is associated with what?
altered BRCA1/2 or p53
What is associated with greater than 70% breast cancer ?
BRCA1
Greater than 40% of ovarian cancer is associated with —
BRCA1
Most breast cancer treatment plans use combined modalities. True/False?
True
State what combined modalities in BC comprises of
Primary tumour removed by surgery (mastectomy/lumpectomy)
Radiation therapy to remaining breast and/or axilla
Adjuvant chemotherapy
Hormonal therapy to eradicate any micro-neoplastic disease/prophylaxis
State the genetic test used to determine when to treat a patient
Oncotype DX test
What does RS score mean in oncotype DX test
This suggests the likelihood of cancer coming back
A low RS means what?
Cancer is unlikely to come back
RS is less than 18
A high RS using oncotype Dx suggest what ?
Suggests the cancer is more likely to come back
RS greater than 31
Describe a chemo brain
Chemo brain include disorganized behaviour or thinking, confusion, memory loss, and trouble concentrating, paying attention, learning, and making decisions.
What does SERM stand for?
Selective estrogen receptor modulator
List examples of drugs that are SERMS
Tamoxifen
Droloxifene
Toremifene
Raloxifene
Idoxifene
SERms are called modulators because?
They have both estrogenic and anti-estrogenic property
There are two types of estrogen receptors namely?
Alpha and beta estrogen receptor
State how Tamoxifen work
Tamoxifen is a partial antagonist - it has pro-oestrogenic affects
Associated with oestrogen receptor subtype distribution
Increased incidence of endometrial cancer
Tamoxifen consistently reduces the risk of contralateral breast cancer
State the mechanism of action of Estradiol as a hormonal therapy used in breast cancer treatment
Estradiol binds to the estrogen receptor upon estrogen binding, AFI (ACTIVATION FACTOR), there is dimerization and AF2 is activated, this translocate to the nucleus and binds to the DNA - fully activated transcription
State how Nolvadex(tamoxifen) works.
Tamoxifen binds to estrogen receptor, AFI is activated but upon dimerization, AF2 is not activated, there’s a partial transcription
State how Faslodex works
binds to the estrogen receptor, upon dimerisation, neither AF1 nor AF2 is activated- no co-factors hence, no transcription. hence, they are not pro-estrogenic and it is degraded
