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Breast > Management > Flashcards

Management Flashcards

1
Q

Stage 1-2 breast cancer - local surgical treatment (5)

A
  • Tumour removal by wide local excision or mastectomy
  • Axillary node sampling/surgical clearance or sentinel node biopsy
  • Radiotherapy
  • Adjuvant chemotherapy = epirubicin + CMF
  • Endocrine agents : tamoxifen/aromatase inhibitor
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2
Q

Endocrine agent given in oestrogen positive tumours in young

A

Tamoxifen

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3
Q

3 general aspects of breast cancer treatment

A
  • Lump itself
  • Preventing locoregional recurrence
  • Treat possible mets
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4
Q

What is the purpose of radiotherapy in breast cancer treatment?

A
  • Neoadjuvant: shrink tumour in local area

- Post surgery: prevents locoregional recurrence (site + nodes)

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5
Q

What is the purpose of chemotherapy in breast cancer treatment?

A

Prevents mets systemic spread (detected/not detected)

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6
Q

Adjuvant treatment definition

A

After surgery

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7
Q

Neoadjuvant treatment definition

A

Before surgery

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8
Q

Lumpectomy vs wide local excision

A

1) Used in benign lesions to remove just lesion (not surrounding tissue)
2) Used in malignancy - lesion + surrounding 1-2cm healthy tissue margin

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9
Q

Indications for bilateral mastectomy (3)

A
  • High risk of recurrence
  • Strong family history
  • Triple negative cancer
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10
Q

Definition of full mastectomy

A

Removal of all breast tissue and axillarly tail

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11
Q

Endocrine therapy in older women

A

Aromatase inhibitor

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12
Q

Why are aromatase inhibitors used? (3)

A
  • They don’t stop the ovaries making oestrogen
  • Postmenopausal women don’t make much
  • Esp hormone receptor positive
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13
Q

Common complication of radical mastectomy - presentation (3) And reason?

A
  • Winged scapula
  • Arm abduction weakness
  • Transection of long thoracic nerve =
    serratus anterior lack of innervation
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14
Q

Aromatase inhibitor examples (3)

A
  • Anastrozole
  • Exemestane
  • Letrozole
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15
Q

What is the dose and duration of tamoxifen?

A

5 years post operation

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16
Q

Other treatments after tamoxifen - if premenopausal and ER positive? (2)

A
  • Ovarian ablation (surgery/radiotherapy)

- GnRH analogues

17
Q

What drug is used in HER2 positive tumours?

A

Trastuzumab

18
Q

Treatment for stage 3-4 breast cancers (distant disease)

A

1) Staging investigations:
- CxR
- Bone scan
- Liver USS
- CT/MRI + PET
2) Radiotherapy
3)

19
Q

What is radiotherapy used for? (2)

A
  • Radiotherapy for painful bony lesions

- Osteoclast inhibitors e.g zolendronic acid

Breast (7 decks)

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