E2 Breast Cancer Flashcards
some risk factors for breast cancer
age
family hx
radiation (prior tx for lymphoma)
estrogen exposure
alcohol
high BMI
diet
2 tumor suppressor genes in breast cancer
BRCA 1
BRCA 2
risk assessment tool to determine relative risk in % of developing breast cancer
gail risk model
4 types of breast cancer
invasive carcinoma
ductal carcinoma in situ
lobular carcinoma in situ
inflammatory
Has invaded beyond the basement membrane of duct or lobule
A. invasive carcinoma
B. ductal carcinoma in situ
C. lobular carcinoma in situ
D. inflammatory
A
More common:
A. invasive ductal carcinoma
B. invasive lobular carcinoma
A
Normal cells have undergone pre-malignant genetic transformation
A. invasive carcinoma
B. ductal carcinoma in situ
C. lobular carcinoma in situ
D. inflammatory
B
Usually an incidental finding on biopsy
A. invasive carcinoma
B. ductal carcinoma in situ
C. lobular carcinoma in situ
D. inflammatory
C
T or F:
Ductal and lobular in situ cancers are considered invasive
false, thats why they arent called invasive breast cancer sherlock
aggressive form of breast cancer with rapid onset and poor prognosis
A. invasive carcinoma
B. ductal carcinoma in situ
C. lobular carcinoma in situ
D. inflammatory
D
pt presents with edema, redness, warmth
A. invasive carcinoma
B. ductal carcinoma in situ
C. lobular carcinoma in situ
D. inflammatory
D no fuckin shit
delayed in diagnosis because docs think its probably something else
A. invasive carcinoma
B. ductal carcinoma in situ
C. lobular carcinoma in situ
D. inflammatory
D. (they think its cellulitis)
2 different ways you can test for HER2 status *
1) Immunohistochemistry (IHC): detects protein overexpression
2) Fluorescence In-Situ Hybridization (FISH): detects gene amplification
Genetic test for expression of 21 genes which gives a recurrence score
can determine likelihood that breast cancer will return and whether pt will benefit from chemo
Oncotype Dx
what stages of breast cancer can you use oncotype dx in?
stage I or II
T or F: Oncotype Dx is used in ER negative and HER2 positive cancers
false, other way around. ER pos and HER2 neg
Oncotype Dx: TAILORx:
Low risk (<__) = ________ therapy only
26, hormone
Oncotype Dx: TAILORx:
High risk (>/=__) = ______ and hormonal therapy
26, chemo
Oncotype Dx in LN(+) Disease:
both _________ and __________ patients with LN+ disease
pre and post menopausal
T or F:
Breast cancer can metastasize anywhere
true
for what stages of breast cancer is the goal curing it?
I, II, and IIIA, IIIB, IIIC
Stage I, II, IIIA guidelines
lumpectomy + radiation
OR
modified radical mastectomy +/- radiation
T or F:
Most women will receive adjuvant therapy after surgery) in stages I, II, IIA
True
Stage IIIB and IIIC guidelines
same as I, II, and IIIA but with neoadjuvant chemo before MRM or lumpectomy
Stage IV guidelines
basically whichever combo makes most sense for patient (chemo, hormonal, biologics, immunotherapy)
AND
Surgery is only for symptomatic relief