Nikcevich: Breast Cancer Clinical Cases

Question 1

inject the dye into the breast and it travels via lymphatics. how do they specifically cut up the sentinel lymph-node?

Answer 1

section it top to bottom, and LOTS OF DATA.

Question 2

**PEARL: _____ breast cancer TX w. Tamoxifen and NO CHEMO has a good prognosis, but the recurrence is late (around year 9/10). On the other hand, _____ is treated with CHEMO and it does not recur later!!!!

Answer 2

ER+. Triple negative type breast cancer

Question 3

mastalgia = ________

Answer 3

breast pain

Question 4

**PEARL: _____ carcinomas are often SILENT on a mammogram, therefore needing a breast MRI

Answer 4

LOBULAR.

Question 5

**PEARL: T or F- with a central breast lesion you can perform breast conservation

Answer 5

FALSE. you just cant, regardless of size.

Question 6

**PEARL: when using hormonal therapy, only use AROMATASE INHIBITORS IN _____ (premenopausal or postmenopausal) women.

Answer 6

POSTMENOPAUSAL-

Question 7

if the woman has her-2-neu +++ cancer, will they always receive chemotherapy?

Answer 7

YES + TRASTUZUMAB (for a whole YEAR, $$$ 100,000)

Question 8

T or F: bone-only breast cancer is often an indolent disease

Answer 8

True

Question 9

Breast cancer has reoccurred after 5 yrs, what would be the next step? (A) Biopsy (B) Surgery (C) immediate treatment based on prior diagnosis

Answer 9

BIOPSY. always want to check, it could be another type of cancer

Question 10

what are the goals of breast cancer treatment?

Answer 10

palliative care, prolong survival and quality of life

Question 11

how should your patient with DCIS be treated (46 yrs old)?

Answer 11

SHARED DECISION MAKING. Breast conservation (tx and follow ups) or simple mastectomy (no more trouble)

Question 12

What molecular markers should you collect for DCIS?
(A) ER
B) PR
C) ER/PR
D) ER/PR and Her-2-neu
E) just Her-2-neu

Answer 12

C. DONT BOTHER WITH her-2-neu

Question 13

is DCIS invasive breast cancer?

Answer 13

NO. it’s non-invasive!

Question 14

what is the goal of therapy for DCIS?

Answer 14

reduce risk of local recurrence and reduce risk of developing new invasive carcinoma. NO CHEMO.

Question 15

can you do a mammogram on men or do they need their own special test to examine their manly pecks?

Answer 15

no dah, of course you can do a mammogram on a male!

Question 16

how do you treat a male with breast cancer???

Answer 16

same thing as women, but think about BRCA TESTING. if they have the deleterious BRCA mutation, their 1st degree family members need to be treated as well (apparently)

Question 17

the USPSTF recommends routine mammogram screening for women aged ___-___ years

Answer 17

50-74

Question 18

what is the average lifetime risk in the US for breast cancer?

Answer 18

12%

Question 19

95% of breast cancer is in women over the age of _____

Answer 19

40