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Cameron Breast > Inflammatory Breast CA > Flashcards

Inflammatory Breast CA Flashcards

1
Q

What is the 5-year survival for pts with inflammatory breast cancer compared to all pts with invasive breast CA?

A

Inflammatory breast CA: 40%. All pts with invasive dz: 87%

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2
Q

T/F: Inflammatory breast CA is seen more often in blacks than in whites?

A

TRUE

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3
Q

What is the cause of peau d’orange?

A

Plugging of the dermal lymphatics with subsequent edema of the tissues around exaggerated hair follicles

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4
Q

What is the differential dx of inflammatory breast cancer?

A

Mastitis, abscess, lymphoma, venous congestion, dermatitis, and locallly advanced breast CA

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5
Q

Do women with suspected inflammatory breast CA still need a mammogram?

A

Yes

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6
Q

How does one confirm the dx of inflammatory breast CA?

A

Punch bx of skin. Seeing tumor emboli in the dermal lymphatics

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7
Q

What is often the receptor status of inflammatory breast CA?

A

ER-/PR-, 50% of cases HER2/neu+

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8
Q

Inflammatory breast cancer is automatically what breast CA stage?

A

IIIc (T4d, N0-N3, M0)

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9
Q

What fraction of pts with inflammatory breast CA will have distant metastatic spread?

A

1/3

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10
Q

What is the metastatic work-up for breast CA?

A

CBC, LFTs, whole-body bone scan, CT C/A/P +/- PET scan

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11
Q

What is the first-line therapy for inflammatory breast CA?

A

Neoadjuvent chemotherapy

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12
Q

What neoadjuvent chemo is used for inflammatory breast CA?

A

Anthracycline-based regimens +/- taxane

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13
Q

Trastuzumab cannot be given concurrently with what chemotherapy agent? Why?

A

Anthracycline because it can potentiate cardiotoxicity

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14
Q

If a pt with inflammatory breast CA responds to neoadjuvent chemo, what is the next step?

A

Surgery

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15
Q

If a pt w/ inflammatory does not respond to neoadjuvent chemo, what is the next step?

A

XRT

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16
Q

What are the response rates for neoadjuvent chemotx for pts with inflammatory breast CA?

A

Clinical response rate 86%. Pathologic complete response: 12-33%.

17
Q

When should surgery be done after chemotherapy for inflammatory breast CA?

A

3 weeks to allow the cytotoxic effects to normalize

18
Q

What is the surgery for inflammatory breast CA?

A

modified radical or total mastectomy with complete axillary node dissection

19
Q

Are breast conservation or SLNBx ever indicated for inflammatory breast CA?

A

No

20
Q

Tissue reconstruction of the breast following a mastectomy for inflammatory breast CA is delayed how long after XRT?

A

6-12 months

21
Q

After a mastectomy for inflammatory breast CA XRT is recommended for which pts?

A

All, regardless of response to chemotherapy

22
Q

What endocrine therapy is indicated for pts with ER+ inflammatory breast CA following adjuvent therapy?

A

Tamoxifen for premenopausal women and an aromatase inhibitor in postmenopausal women

Cameron Breast (9 decks)

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