Neoplasms Flashcards
What is the most common type of breast cancer?
Invasive ductal carcinoma is the most common. 70-80%. Tend to mets to axillary lymphatic system.
What is Paget’s disease of the breast?
Chronic eczematous, itching, scaling rash of the nipple & areola.
+/- Bloody discharge & lump
What is Inflammatory breast cancer?
fast & aggressive infiltration of the lymph nodes and skin. No lumps associated
Inflammatory breast cancer presentation?
red swollen, warm, itchy breast with nipple retraction and breast skin dimpling (due to block of the lymph vessels) = prognosis.
What is peau d’ orange and what is it associated with?
skin dimpling similar to orange peel due to lymphatic blockage associated with inflammatory breast cancer.
What is triple-negative?
Her 2 negative, Estrogen (ER) negative and Progesterone (PR negative)
What is the initial imaging modality to evaluate breast masses in women under 40 ?
Ultrasound because younger women’s breasts tend to be denser and harder to read with mammography
What is the initial imaging modality to evaluate breast masses in women over 40 ?
Mammography
What are the MC distant site of mets for breast cancer? HINT 2B’s & 2L’s
Brain & Bone
Liver & lungs
What are the biopsy options for the evaluation of a breast mass?
Fine needle aspiration
Core biopsy
Open biopsy
What medications are used for estrogen + receptors in the breast?
Premenopausal: tamoxifen
Postmenopausal: aromatase inhibitors (letrozole, anastrozole, exemestane)
What medications are used for human epidermal growth factor receptor 2 (HERs) positive receptors in the breast?
Monoclonal therapy: trastuzumab
What are the USPTF guidelines for mammograms?
Every 2 years starting at the age of 40 -74 OR 40 y/o if increased risk factors
When should clinical breast exams be conducted?
every 3 years in women age 20-40 then annually after age 40.
How does endometrial cancer typically manifest?
women present with abnormal or postmenopausal uterine bleeding
What would transvaginal u/s show in a pt with endometrial cancer?
thickened endometrial stripe >4mm.
post-menopausal women should have an endometrial stripe <4mm
What is the most common type of endometrial cancer
adenocarcinoma: represents 80% of all diagnosed endometrial cancers and is associated with excess estrogen.
What is the most common type of vulvar cancer?
Squamous cell carcinom
Vulvar cancer is most common in?
older women
What are the presentations of vulvar lesion?
firm; white, red, or skin-colored; nodules, papules, or plaques; and have varying degrees of erosion or ulceration.
How is vulvar cancer diagnosed?
colposcopy + Bx
What are the risk factors for vulvar cancer?
human papillomavirus (16 &18)
prior vulvar or cervical intraepithelial neoplasia,
prior history of cervical cancer, cigarette smoking, and immunodeficiency syndromes.
Breast cancers that are HER2 receptor-positive should be treated with?
trastuzumab, a monoclonal antibody to the HER2 receptor after surgical excision
What is the physical appearance of paget disease of the vulva?
well-demarcated, slightly raised, erythematous vulvar lesion with an eczematoid appearance.
A pruritic vulvar lesion that does not resolve within 6 weeks of eczema therapy is suspious for?
Paget disease of the vulva & should be Bx
What is the most common symptom of Paget disease of the vulva?
Itching
Elevated hCG levels can cause nausea and vomiting, hyperthyroidism, and bilateral theca lutein cysts in ?
Gestational trophoblastic disease
Hcg mimics thyroid-stimulating hormone and luteinizing hormone.
characteristic pathology of Choriocarcinoma
sheets of trophoblastic tissue consisting of syncytiotrophoblasts and cytotrophoblasts without villi
What is the most common type vaginal cancer?
Squamous cell carcinoma
-> risk are the same for cervical cancer
What is the name of the drug that causes adenocarcinoma in women?
Diethylstilbestrol
