Management of Breast Cancer Flashcards
what staging is used in breast Ca
TNM
what defines T1, T2 and T3 from each other
T1 = <2cm T2 = 2-5cm T3 = >5cm
what stage is a tumour invading locally
T4
what differentiates N1 and N2
whether the lymph nodes are mobile or fixed
what investigations are done to stage breast Ca
sentinel node biopsy ER and PR status HER2 status FBC and LFTs CXR CT bone scintigraphy PET
name 5 members of the MDT for breast cancer
radiologist, cytologist, clinical oncologist, medical oncologist and breast surgeon
5 modes of breast cancer treatment
surgery radiotherapy chemotherapy hormonal thera[y specific therapies
surgery offered
breast conservation or mastectomy +/- lymph nodes
what treatment must also be given if patient wishes breast conservation
radiotherapy
how long is radiotherapy given for
3 weeks
complications from lymph node removal/Rx
lymphoedema, nerve damage, radiation induced sarcoma and decreased ROM
2 antihormonal agenta
tamoxifen and aromatase inhibitors
indications for tamoxifen
ER+ tumour (block oestrogen)
main risk in tamoxifen
VTE
how do aromatase inhibitors work
block oestrogen receptor synthesis
who should aromatase inhibitors be given to
post-menopausal women
risk of aromatase inhibitors
osteoporosis
who is chemotherapy best in
women <50 y/o with poor prognostic factors
3 chemo options
CMF, anthracycline and taxane combinations
what is Herceptin
aka trastuzumab - a monoclonal antibody against HER2 receptor
what therapy should be given in before herceptin
chemotherapy
3 things that make up the nottingham prognostic index
lymph node involvement
tumour grade
tumour size
poor prognostic factors for recurrence
-ve ER or PR
+ve HER2
high grade
lymph node involvement
which molecular subtypes are ER+ve
luminal A and B
