management in breast cancer Flashcards
what are the prognostic factors associated with breaqst cancer
molecular type of breast cancer
what are the different molecular types of breast cancer
1- luminal A - ER positive, PR positive , Her 2 negative and Ki67 low
2- her 2 positive
3- luminal B - ER positive , PR positive , Her 2 positive and Ki67 high
4- Basal like - all are negative ( triple negative )
local vs systemic therapy in breast cancer
local therapy - surgery and radiotherapy
systemic - chemotherapy , her 2 therapy and endocrinal therapy
what are the indications for radiotherapy in BC patients
radiotherapy in BC is mainly adjuvant
1- all patients that have undergone conservative breast surgery ( also called wide local excision )
2- all patients undergone mastectomy that had a mass >5 cm or positive nodes
3- in locally advanced disease
most accurate form of radiotherapy ?
IMRT
when is palliative radiotherapy used ?
mainly in metastatic patients
what are the indications for adjuvant chemotherapy ?
nodal positive or locally advanced
when is hormonal therapy used
for ER and PR positive
(luminal A or luminal B )
what are the strategies used to overcome endocrinal resistance in BC
Anti CDK4-6 inhibitor
Afinitor
( inhibition of cross talk )
anti her 2 therapy
over expression of her 2 receptors
trastuzumab
pertuzumab
indications for herceptin
1- first-line treatment of HER2-overexpressing metastatic breast cancer in combination with paclitaxel
2- indicated for adjuvant therapy in Her 2 breast masses that are over 1 cm
management for BRCA mutation BC
parp inhibitors
Olaparib
bone target agents
zoledronic acid
denusomab
biphosphonates
to decrease thee risk of pathological fractures
what is proliferation measured by ?
Ki67
