Neoplasms Flashcards
what are risk factors for breast cancer
menarche before 12
advanced maternal age of first full-term pregnancy, no pregnancies
menopasuse after age 52
what is the most common type of breast cancer
infiltrating intraductal cacinoma (IIC)
what are treatment options for breast cancer
segmental mastectomy (lumpectomy)
adjunctive chemotherapy
anti-estrogen Tamoxifen in tumors ER-positive
Aromatase inhibors - useful in postmenopausal ER-positive
Monoclonal AB treatment - useful on HER2 positivity
what clinical triad is strongly indicative of cervical cancer extension to the pelvic wall?
Unilateral leg edema
sciatic pain
ureteral obstruction
what are risk factors for carcinoma of the cervix
Multiple sexual partners
early age at first intercourse
early first pregnancy
HPV positive
how is cervical cancer diagnosed
friable, bleeding cercial lesion on exam
biopsy of gross lesion of colposopically directed biopsies
what is the most common type of cervical cancer
invasive squamous cell arising from exctocervix
what is the treatment of cervical cancer
resect and/or chemotherapy and radiation
at what age should your patient recieve their first PAP regardless of sexual activity?
age 21
what are pap smear screening recommendations
- women age 21 to 29 - only cytology screening every 3 years
- woman over 30 years or older - combo cytology + HPV teesting is recommended every 5 years
- annual screening recommended for any high risk groups
what are recommendations for discontinuation of PAP smear screening
- no cytology after total hysterectomy if surgery for benign condition
- discontinue screening at age 65 for women who have had adequate recent screening
what does ASC-US mean
Atypical squamous cells of undetermined significant
what does LSIL mean
Low-grade squamous intraepithelial lesion, that is, mild dysplasia, CIN I
what does HSIL mean
high-grade squamous intraepithelial lesion, that is, moderate to severe dysplasia, CIN II-III, carcinoma in situ
what types of HPV are risk factors for cervical dysplasia and can lead to cervical cancer
HPV 16, 18 and 31
what are HPV vaccine recommendatiosn for females
recommended at 11 to 12 years old
can be administered starting at 9 years old
what is the HPV vaccine dosage recommendations?
< 15 years old: administer a two - rather than 3 dose vaccine series
> 15 years old: HPV vaccine in 3 doses at 0, 1 to 2 months and then at 6 months
what is the cardial symptom of endometrial cancer
postmenopausal vaginal bleeding
what is the most common type of endometrial cancer
adenocarcinoma
what are risk factors for endometrial cancer
obesity
nulliparity
early menarache
late menopause
unopposed estrogen stimulation
HTN
Gallbladder disease
DM
Prior ovarian, endometrial or breast cancer
how is endometrial cancer diagnosed
endometrial biopsy - gold standard
what is the treatment of endometrial cancer
total hysterectomy and bilateral salpingo-oophorectomy
pelvic radiation therapy with or without chemo for stage 2 and 3 cancer
what presentation of ovarian cancer
40-60yo
ascites
abdominal pain
what are protective factors for ovarian cancer
multiparity
OCP use and breast feeding
what are risk factors for ovarian cancer
nulligravidity (or infertility)
early menarche
late menopause
endometriosis
what is the typical etiology of ovarian cancers
epithelial tumors
germ cells are more common in pts < 10 yo
how is ovarian cancer diagnosed
TVUS then biopsy
serum tumor marker CA-125 - BRCA1 gene
what are known risk factors for vulvar/vaginal carcinoma?
HPV infection
smoking
coexisting cervical carcinoma
in utero exposure to DES
what is the most common location of vaginal carcinoma
Upper one-third of posterior vaginal wall
what is the treatment of vaginal cancer
radiation therapy
what is the most common presentation of vulvar cancer
vaginal pruritus
what is the most common etiology of vulvar cancer
squamous cell cancer and melanoma
what is the treatment of vulvar cancer
vulvectomy and lymph node dissection
