Onc Flashcards
Screening cervical cancer starts at age
21
Mammography screening starts at age
Age 40
Q1-2 years
Yearly at 50
Colorectal cancer screening
Age 50 Stop at age 85 FmHx of FAP (APC?) = begin a puberty HNPCC = begin at age 21, Q1-2 years Small adenoma = 3-5 years after polypectomy (< 3 years if > 1 cm)
Neutropenic fever
Neutrophil < 1000 and single fever > 100.9
Start emperic therapy
Breast cancer screening ages
Start mammogram age 40
Stop at age 75
Breast lump < Age 30
US
> 30 diagnostic mammography
BI-RADS
0 incomplete 1 negative 2 benign 3 probably benign 4 suspicious 5 highly suspicious 6 proven malignancy
Eczematous breast lesion
Paget disease
Unilateral watery or serous nipple discharge
ductal carcinoma
Bloody nipple discharge
intraductal papilloma
Only drug approved for chemoprevention in Premenopausal women
Tamoxifen = SERM
- Increased VTE, stroke, endometrial cancer (can’t use TVUS to determine thickness, need to do biopsy)
- SE= vasomotor symptoms
**Use aromatase inhibitors (anastrazole) only in post-menopausal women (less thrombosis, EMCA, and vaginal bleeding compared to tamoxifen), or in pre-menopausal women with risk factors
BRCA mutations account for what amount of Ovarian Cancer?
20-25%
4% of breast cancer
BRCA 1 on what chromosome?
Chromosome 17
BRCA 2 on what chromosome?
Chromsome 13
Risk reducing BSO reduces risk of cancer by what percent in BRCA1 patient?
85%-95%
*Perform at age 40 or when done childbearing
Risk of malignancy with complex hyperplasia with atypia?
30%
Types of endometrial cancer
Type 1 = from unopposed estrogen
Type 2 = 20%, clear cell, papillary serous, some grade 3 endometrioid, this, elderly women (poor prognosis)
Low grade endometrial CA in pts that desire fertility?
Treat with high-dose progestin (76% response rate)
Poor surgical candidates = Mirena or Megace
Thickness of EMS on US that require biopsy in post menopausal women?
> 4 mm
Rapid enlargement of uterus concerning for….
sarcoma
What ovaria tumor produces estrogen?
Granulosa cell tumors = inhibin A and B
Produce estrogen
Call-exner bodies on pathology
Need to do endo biopsy, will have thickened endometrium
Most common germ cell ovarian tumor?
Dysgerminoma
CA-125
epithelial carcinoma
CEA
Mucinous epithelial tumor
High risk HPV supbtypes
16, 18, 31, 33, 35
HPV vaccine
3 shots (0,2, 6 months) Contraindicated during pregnancy
Risk of GTN following a complete mole?
15-20%
Most common cause of PMB?
Atrophic Endometrium
Depending on age and risk factors 1-14% will have endometrial cancer
What HPV strain has the highest carcinogenic potential?
HPV 16
