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PHM703 Heme/Onc/Crit Care > Exam 3 - Breast Cancer > Flashcards

Exam 3 - Breast Cancer Flashcards

1
Q

List non-modifiable risk factors for breast cancer?

A

female, older age, family history, genetics (BRCA1/2), breast changes on biopsy, radiation, early menarche/late menopause

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2
Q

List modifiable risk factors for breast cancer?

A

nulliparity or older age at first childbirth, postmenopausal HRT or obesity, physical inactivity, alcohol consumption

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3
Q

Explain screening recommendations for breast cancer?

A

all women should have breast awareness, women aged 25-39 exam every 1-3 years, aged 40+ annually

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4
Q

List signs/symptoms of breast cancer?

A

palpable mass, pain, discharge, retraction, dimpling, skin changes (redness, warmth, edema)

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5
Q

What are chemo treatments for hormone +/-, HER2- breast cancer? (3)

A

dose-dense doxorubicin/cyclophosphamide (AC) q2w x4 then paclitaxel q2w x4, dose-dense AC x4 then paclitaxel qw x12, docetaxel and cyclophosphamide q3w x4-6

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6
Q

What is treatment for hormone -, HER2- (triple negative) breast cancer?

A

pembrolizumab q3w x4 plus paclitaxel/carboplatin qw x12 then pembrolizumab plus AC q3w x4 then surgery then pembrolizumab q3w x9

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7
Q

What are treatments for HER2+ breast cancer? (2)

A

docetaxel/carboplatin/trastuzumab plus pertuzumab q3w x6, paclitaxel plus trastuzumab qw x12

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8
Q

What is the MoA of trastuzumab and pertuzumab?

A

inhibits HER2 homodimerization and HER2-mediated signaling

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9
Q

What are AEs of HER2 targeted therapies (trastuzumab/pertuzumab)?

A

cardiotoxicity, diarrhea, infusion-related reactions

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10
Q

What is the MoA of SERMs (tamoxifen/raloxifene)?

A

blocks estrogen binding site in some tissues depending on location in body

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11
Q

What is the MoA of aromatase inhibitors (anastrazole/letrozole/esemexane)?

A

suppress plasma estrogen levels by inactivating aromatase

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12
Q

What hepatic enzyme is important for tamoxifen metabolism to active form, endoxifen?

A

CYP2D6

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13
Q

What is treatment for premenopausal women receiving endocrine therapy for breast cancer?

A

tamoxifen, aromatase inhibitor plus ovarian suppression

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14
Q

What is endocrine therapy for postmenopausal women with breast cancer?

A

aromatase inhibitor, tamoxifen

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15
Q

What are treatments for ovarian suppression? (2)

A

oophorectomy, LHRH agonists (goserelin, leuprolide)

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16
Q

What are the AEs of SERMs (tamoxifen/raloxifene)? (3)

A

menopausal symptoms (hot flashes, vaginal dryness), uterine/endometrial cancers, thromboembolic events, AVOID pregnancy

17
Q

What are the AEs of aromatase inhibitors? (5)

A

menopausal symptoms (hot flashes, vaginal dryness), musculoskeletal symptoms, bone loss, hypercholesterolemia, CV risks

18
Q

What is additional adjuvant therapy for triple negative breast cancer?

A

capecitabine

19
Q

What is additional adjuvant therapy for HER2+ breast cancer?

A

ado-trastuzumab emtansine

20
Q

What is additional adjuvant therapy for hormone +/- HER2- breast cancer?

A

neratinib

21
Q

What is additional adjuvant therapy for BRCA mutated breast cancer?

A

olaparib

22
Q

What is additional adjuvant therapy for homone + HER2- high-risk breast cancer?

A

abemaciclib

23
Q

What is additional adjuvant therapy for postmenopausal patients at osteoporotic risk?

A

zoledronic acid for 2 years

24
Q

List the cyclin-dependent kinase 4/6 inhibitors? (3)

A

palbociclib (Ibrance), ribociclib (Kisqali), abemaciclib (Verzenio)

25
Q

What are endocrine therapies for metastatic breast cancer? (3)

A

CDK 4/6 inhibitors (palbo/ribo/abemaciclib), everolimus, alpelisib

26
Q

What is combined with CDK 4/6 inhibitors, mTORis, and alpelisib after disease progression?

A

fulvestrant (Faslodex)

27
Q

What is the MoA of everolimus (Afinitor)?

A

inhibits mammalian target of rapamycin (mTOR)

28
Q

What are AEs of everolimus (Afinitor)? (4)

A

rash, stomatitis, pneumonitis, metabolic disturbances

29
Q

What is the MoA of alpelisib (Piqray)?

A

small-molecule phosphatidylinositol-3-kinase (PI3K) inhibitor

30
Q

What is the indication for alpelisib (Piqray)?

A

hormone +, HER2-, PIK3CA-mutated metastatic breast cancer

31
Q

What are treatments for breast cancer metastases to bone? (2)

A

bisphosphonates (zoledronic acid, pamidronate), denosumab

32
Q

List the survivorship issues for breast cancer patients? (8)

A

hot flashes, sexual problems, infertility, lymphedema, osteoporosis, neuropathy, cardiac toxicity, secondary malignancies

PHM703 Heme/Onc/Crit Care (18 decks)

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