MTB 1 Flashcards
Best initial test for Breast Cancer
FNA BX
Breast cancer findings on PE
Hard to touch
Retraction of nipple
Painless
How to test for estrogen/progesterone/HER2/neu receptors?
Core needle Bx - more deforming
Most accurate Dx test for breast cancer
Open BX - frozen section in OR w immediate resection
When do we screen w mammography?
Start at 50 yoa
When do we do US in breast cancer
Indeterminant mass lesions
Painful
Varies w menstruation
- US tells cysts v solid lesions
When do we do PET in breast cancer
To determine content of LNs not accessible by Bx
How does cancer present on PET
Cancer increases uptake on PET
BRCA ass’d with?
Breast ca
Ovarian ca
When do we Bx Sentinel Node
Routinely in all pts when lumpectomy or masectomy is done
When is ER and PR testing done
Routinely in all pts
Why is radiation important in breast cancer TX
Indispensible in preventing recurrences
What AEs do aromatase inhibitors cause
Osteoporosis
Trastuzumab
MOA
Benefit
Anti-Her2/neu Abs
Decreases risk of recurrent dz
When do we do adjuvant chemo in breast cancer
Lesions > 1cm
Positive axillary LN
DOC when multiple first degree relatives w breast cancer and why
Tamoxifen
Lowers risk of breast cancer
Best initial test Prostate Cancer
BX
Most accurate test Prostate Cancer
BX
TX for Prostate Cancer
Surgery - prostatectomy
AEs of Prostatecomy
ED
Urinary Incontinence
What does Gleason Grading measure
Aggressiveness
Malignant potential
Management that is WRONG in prostate cancer
Screening imaging
Lumpectomy
Chemo
High PSA + Palpable mass = next step?
BX the mass
High PSA + No Palpable mass = next step?
Transrectal US
- if Mass seen = BX
- if no mass seen = multiple blind BX’s
When do we not do surgery in Lung Cancer
Bilateral
Malignant pleural effusion
Heart, Carina, Aorta, Vena Cava involved
Which cancer is unresectable in 95%
Small cell - mets outside lung
What kind of cancer is Lip cancer?
Causes
Presentation
SQCC - invasive cords of squamous cells w keratin pearls
Sun exposure
Vermillion zone of lower lip
non-healing
Ovarian Cancer presentation
Woman > 50 yoa
Increasing abdominal girth
Weight loss
Ovarian Cancer
Initial test
Accurate test
Initial Test: US or CT
Accurate: Bx
Tx for Ovarian Cancer
Resection - all visible tumor and pelvic organs
Chemo
Presentation of Testicular Cancer
Painless Lump in scrotum
Does NOT transilluminate
Test for Testicular Cancer
Remove whole testicle w inguinal orchiectomy
Never needle Bx
Which testicular cancers secrete AFP
Nonseminomatous cancers
TX for Testicular Cancer
- Orchiectomy
- Radiation for Local
Chemo for widespread
How does Testicular Cancer Metastasize
Thru Lymphatics in retroperitoneum and moves into chest
What is TX for Brain mets w solitary lesion
Surgical resection + Whole brain Radiation
What is TX for Brain mets w multiple lesions
Palliative
Whole Brain Radiation
Glucocorticoids
Management of Advanced cervical cancer
Hysterectomy
