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Master the Boards > Oncology > Flashcards

Oncology Flashcards

1
Q

best initial test breast cancer

A

biopsy

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2
Q

which type of biopsy is the best initial for breast cancer

A

FNA

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3
Q

FN rate of FNA for breast cancer

A

10%

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4
Q

core needle biopsy

A

LARGER SAMPLE, more deforming, ER/PR/HER2/Neu; possibility that needle will miss the lesion

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5
Q

most ACCURATE bx type for breast cancer

A

open biopsy– frozen section while in operating room; followed by immediate resection of cancer, followed by sentinel node bx

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6
Q

mammography screening– age start at

A

50yo

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7
Q

NB even if already getting FNA

A

do MAMMOGRAPHY – since 5-10% of patients = bilateral

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8
Q

MRI use for breast cancer

A

PRECISE USE NOT clear yet;

young woman with dense breasts

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9
Q

US breast cancer

A

indeterminant mass lessions
cystic vs. solid
if the lesion is PAINFUL
or VARIES in size/pain with MENSES

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10
Q

PET scan breast cancer

A

determine CONTENT of abnormal lymph nodes that are not easily accessible to biopsy

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11
Q

BRCA testing

A

a.w increased risk of breast cancer

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12
Q

other cancers a/w BRCA

A

PANCREATIC and OVARIAN cancer

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13
Q

BRCA positive… now what

A

WILL NOT BE ASKED–since NOT yet shown to add mortality benefit to usual mgmt;
(most go for bilateral mastectomy)

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14
Q

sentinel lymph node biopsy

A

done AT THE TIME of lumpectomy/mastectomy

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15
Q

negative sentinel node

A

ELIMINATES NEED FOR axially lymph node dissection

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16
Q

RADIATION for breast cancer

A

INDISPENSIBLE in preventing cancer RECURRENCES

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17
Q

premenopausal option of hormone manipulation breast cancer

A

tamoxifen

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18
Q

postmenopausal option of hormone manipulation breast cancer

A

aromatase inhibitors

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19
Q

letrozole

A

aromatase inhibitor

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20
Q

exemestane

A

aromatase inhibitor

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21
Q

side effect of aromatase inhibitors

A

OSTEOPOROSIS

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22
Q

RADICAL MASTECTOMY

A

ALWAYS the wrong answer

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23
Q

trastuzumab…

A

DECREASES risk of recurrent disease

INCREASES survival

24
Q

adjuvant chemotherapy for breast cancer

A
  • lesions > 1 cm

- positive axillary nodes are found

25
Q

use tamoxifen when …

A

multiple FDR’s have breast cancer,

LOWERS RISK of breast cancer

26
Q

lowering mortality

A
  • mammography
  • ER/PR testing, then tamoxifen/raloxifene
  • aromatase inhibitors
  • adjuvant CHEMO
  • LUMPECTOMY and RADIATION
  • modified radical mastectomy
  • TRASTUZUMAB (anti-Her 2/neu)
  • prophylaxis with tamoxifen/ raloxifene
27
Q

best initial test for prostate cancer

A

BIOPSY

28
Q

which is better for survival

A

prostatectomy MAY SLIGHTLY benefit more than radiation

29
Q

complications of prostatectomy

A

erectile dysfunction

urinary incontinence

30
Q

erectile dysfunction more likely post-prostatectomy OR radiation

A

post-prostatectomy

31
Q

side effect of radiation

A

diarrhea

32
Q

gleason grading

A

AGGRESSIVENESS or the

MALIGNANT POTENTIAL of prostate cancer

33
Q

high glassine grade

A

GET IT OUT before it mets

34
Q

helping to control size and progression of mets for prostate cancer

A

flutamide
GnRH agonists (leuprolide)
ketoconazole
orchiectomy

35
Q

prostate US screening for prostate cancer

A

NOOOOOOO, always wrong

36
Q

prostate US use…

A

localize lesions to biopsy if high PSA

37
Q

lumpectomy for prostate cancer

A

NOOOOOOO, always wrong

38
Q

PSA

A

NO clear mortality benefit
should NOT be routinely offered to patients
normal PSA doesn’t exclude possibility of prostate cancer
above age 75– DO NOT DO IT– EVEN IF ASKED

39
Q

PSA and cancer

A

higher the PSA, GREATER RISK of cancer– corresponds to volume of cancer

40
Q

patient is requesting a PSA to screen for cancer….

A

DO THE TEST

41
Q

surgery for lung cancer

A

SIZE DOES NOT MATTER– depends on the surrounding lung (ie. BIG lesion with normal surrounding, vs. small lesion with abnormal surrounding)

42
Q

CANNOT DO SX FOR LUNG CANCER

A
  • bilateral disease or lymph nodes positive on opposite side
  • malignant pleural effusion
  • involvement: heart, carina, aorta, vena cava
43
Q

screening for lung cancer

A

low dose chest CT:

  • 30 pack years
  • age 55-80
44
Q

ovarian cancer screening…

A

NOOOOOO SCREENING

45
Q

ovarian cancer tx

A

ONLY CANCER– where removing local metastatic disease will benefit the patient

46
Q

cutting the scrotum for testicular cancer

A

NOOOOOOOOO DO NOT DO IT

47
Q

needle biopsy of the testicle

A

NOOOOO WRONG– since seeding

48
Q

after seminoma orchiectomy, for local disease

A

radiation

49
Q

after seminoma orchiectomy, for widespread disease

A

chemo

50
Q

seminomas are sensitive to

A

CHEMO and RADIATION

51
Q

non-seminomas are sensitive to

A

CHEMO only

52
Q

does Pap smear lower mortality as much as mammography or colonoscopy

A

NOOOOO it doesn’t

53
Q

HPV vaccines

A

all women between 11-26yo

54
Q

pap smears

A

starting at age 21, repeat every 3 years until 65yo

55
Q

of women with fatal cervical cancer– what % have never had a pap smear

A

85%

56
Q

ASCUS present

A

do HPV testing

–> colposcopy

57
Q

ASCUS not associated with hpv

A

repeat pap smear at 6 months

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