Thursday - Breast cancer genetics - Nikcevich

Question 1

aromatase inhibitors are only for postmenopausal women

Answer 1

k

if you need to use one, you can induce menopause

Question 2

38 yo gets breast pain after giving birth
exam is unremarkable
mammogram shows vague density
next step?

Answer 2

MRI

Question 3

infiltrating lobular carcinoma can be silent on the mammogram

Answer 3

so if it’s negative, maybe do an MRI just incase

Question 4

her2 positive

Answer 4

automatically high risk

Question 5

best treatment that has ever come out for breast cancer

Answer 5

herceptin = trastuzumab

Question 6

58 yo nurse. right shoulder pain
lytic lesions on humerus
biopsy shows ER+/PR+, her2 -

Answer 6

metastatic
got an aromatase inhibitor
metastatic is incurable
- goals of tx = symptom

Question 7

57 yo with mass
mammo
shows grade 1 no nodes
it recurred 5 years later. now what?

Answer 7

PET scan shows shit everywhere. looks like chirstmas lights

went into clinical trial - follow us is a lot better

Question 8

46. feels fine. annual mamo
    shows calcification
    next step?

Answer 8

biobsy
.6cm ductal carcinoma no invasiveness
gets a lumpectomy
got temoxofen
goal is to reduce risk of recurrence
no chemo

Question 9

62 male. soreness behind nipple
feel something in lymph node and areola
next step?

Answer 9

mammo
2cm mass
ER+/PR-
stage III
tx = same as female
 should be checked for BRCA becuase may help family screening
temoxofen

Question 10

82 yo female. new density in breast on screening

2cm mass

get biopsy

non-hodgkin lymphoma. marginal zone

now what

Answer 10

CT showed many lymph nodes in axilla and lungs

stage 4

tx = rituximab

complete remission

basically remember, not everything is breast cancer

Question 11

57 female w IV ovarian cancer. getting chemo

gets right breast swelling and tenderness and neurotpenic

Answer 11

mastitis

amoxicillin/clavulanic acid

edema stays, do another mammo. mass. biopsy.
it’s metastatic to breast from ovary

Question 12

gail model

Answer 12

measures age, reproductive risk. family hx and biopsy hx

not applicable to
women with prior cancer
under 35
hx of chest radiation
BRCA mutations
men