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mammo > treatment options > Flashcards

treatment options Flashcards

1
Q

4 treatment options

A

surgical
reconstruction
nonsurgical
therapy

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2
Q

purpose is to eradicate the disease in the breast and lymph

A

surgery and radiation

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3
Q

5 surgical options

A

lumpectomy/breast conserving surgery/wide local excision WLE
total/simple mastectomy
radical mastectomy
modified radical mastectomy
axillary lymph node dissection ALND

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4
Q

indications for a certain procedure:
benign breast lumps
high risk lesions
cancerous lesions
if done for cancer treatment usually followed by radiation therapy

A

lumpectomy

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5
Q

2 benign breast lumps

A

fibroadenoma
phyllodes tumor

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6
Q

3 high risk lesions

A

lobular carcinoma in situ LCIS
papilloma
atypical ductal hyperplasia ADH

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7
Q

2 cancerous leions

A

ductal carcinoma in situ DCIS
invasive ductal carcinoma IDC

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8
Q

lumpectomy risk factors

A

bleeding/hematoma
infection
pain
temporary swelling
tenderness
hardening of scar tissue
change in shape of breast

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9
Q

3 types of mastectomys

A

total
skin sparing
nipple sparing

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10
Q

indications for a certain procedure:
DCIS
stages 1,2,3
B CA in more than one quadrant
inflamm B CA- after chemo
paget’s disease
locally recurrent B CA
prior B CA with radiation
high risk lesions
carrier of gene mutation
prophylactic surgery

A

mastectomy

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11
Q

mastectomy risk factors

A

bleeding
infection
pain
swelling (lymphedema)
scar tissue hardening
shoulder pain and stiffness
numbness
hematoma

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12
Q

removal of breast tissue including skin, areola, nipple; reconstruction can be performed immediately or at a later time

A

total mastectomy- simple

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13
Q

removal of breast tissue, nipple and areola but not the skin; skin left behind for reconstruction which can be performed immediately

A

skin sparing mastectomy

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14
Q

removal of only breast tissue, spares skin, nipple and areola; reconstruction performed immediately

A

nipple sparing mastectomy

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15
Q

surgical removal of one or both breasts in a woman at high risk of breast cancer to reduce her risk; reduces risk of recurrence 90%; irreversible decision; usually followed by implant reconstruction

A

prophylactic mastectomy

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16
Q

3 reconstruction options

A

breast reconstruction with implants- immediate or delayed
breast reconstruction with your own transplanted tissue- autologous
no reconstruction- use prosthesis

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17
Q

own transplanted tissue

A

autologous

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18
Q

2 types of autologous reconstruction- flap reconstruction

A

TRAM- transverse rectus abdominus myocutaneous- most common
latissimus dorsi

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19
Q

surgical procedure that uses the tissue and muscle from abdominal area to breast and form a new breast mound; skin, muscle, fat and blood vessels transferred

A

transverse rectus abdominus myocutaneous TRAM

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20
Q

surgical reconstruction procedure that skin, tissue, muscle used from upper back to create breast mound; smaller amount of tissue; used on smaller to medium sized breasts

A

latissimus dorsi flap reconstruction

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21
Q

complications of flap reconstruction

A

muscle weakness
more extensive
larger incisions
longer healing time
longer hospital stays
may need more than one surgery
change in breast sensations

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22
Q

advantages of flap reconstruction

A

help make patient feel whole again
alternative to implants
improve self esteem and body image
helps breasts look natural under clothing
avoid the need for an external prothesis

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23
Q

3 non surgical options

A

radiation
chemo
hormone

24
Q

a radiation therapy which may be used to treat B CA at almost any stage;
commonly used on lumpectomy;
also used to control B CA that has spread;
can still be recommended for mastectomy patients; begins a few weeks after surgery or 3-4 weeks after chemo if needed;
burn to chest wall;
usually given daily 5-6 weeks;
fatigue;
kills abnormal and normal cells;
treatment itself is painless

A

external beam radiation therapy EBRT

25
Q

deposits energy directly to site
spares surrounding tissue
may cause fewer side effects
limited availability

A

external beam radiation therapy- proton beam therapy

26
Q

external beam radiation therapy for a certain procedure:
surgeon goes in and “scoops out” the affected tissue;
relatively higher chance of CA recurring in the same breast if no radiation;
3-15% chance for recurrence in the first 10 years

A

lumpectomy

27
Q

external beam radiation therapy for a certain procedure:
whole breast is removed;
radiation indicated: high risk recurrence rate on chest wall;
have a 5-10% chance of recurrence

A

mastectomy

28
Q

1 type of external beam radiation therapy

A

proton beam therapy

29
Q

2 types of internal radiation therapy

A

brachytherapy
intra-operative radiation therapy

30
Q

3-5 day therapy/twice a day, a catheter is connected to a machine that inserts a radiation seed; high dose radiation to site only; once therapy is complete, seed is removed, patients return to normal daily activities; catheter/balloon are removed on final day

A

internal radiation therapy- brachytherapy radiation seed

31
Q

radiation therapy given during lumpectomy surgery right after the CA has been removed; while the underlying breast tissue is still exposed, a single, high dose of radiation is given directly to the area where the cancer was removed

A

intra-operative radiation therapy IORT

32
Q

4 systemic therapy types

A

chemotherapy
hormone therapy
anti-HER2 therapy
ovarian ablation

33
Q

goal: to stop cancer cell growth, targets rapidly dividing cells
used to kill breast cancer cells; frequently used in conjunction with other treatments; it can increase the chance of cure; decrease chance of recurrence; alleviate symptoms; help live a longer and better quality of life

A

chemotherapy

34
Q

indications for a certain procedure:
NEO Adjuvant Therapy (before surgery)- shrink tumor size and conserve tissue; decrease the extent of disease; decrease chance cancer will return

Adjuvant Therapy (after surgery)- usually recommended if cancer has spread to lymph nodes; premenopausal women; HER2 positive cancer; with some advanced stage cancers or metastatic cancers; triple negative B CA; inflammatory B CA

A

chemotherapy

35
Q

another name for “before surgery”

A

NEO adjuvant

36
Q

another name for “after surgery”

A

adjuvant

37
Q

2 types of chemotherapy

A

IV
oral

38
Q

another name for hormonal therapy

A

endocrine therapy

39
Q

goal is to block the effects of hormones on cancer cell, stop cancer cell growth; estrogen/progesterone receptors; serm- anti estrogen drugs;
positives: for pts at high risk; shown to reduce risk of recurrence; reduce risk of metastatic cancer growth and progression; shown to strengthen bones

A

hormonal therapy

40
Q

proteins found on the surface and inside some cancer cells; when hormones attach here, they cause cancer cell growth

A

hormone receptors

41
Q

type of hormonal therapy useful in postmenopausal women; reduces the amount of estrogen in the body

A

aromatse inhibitors

42
Q

2 hormone therapy types

A

estrogen/progesterone
anti-HER2/ neu therapy

43
Q

protein receptors on surface that stimulates cell growth

A

HER2

44
Q

oldest form of systemic therapy for premenopausal women; shuts down ovaries to reduce female hormone production

A

ovarian ablation

45
Q

tumor does not have any protein receptors; poorer prognosis if left untreated; chemo works best; can be more aggressive and difficult to treat

A

triple negative breast cancer TNBC

46
Q

treatment for early breast cancer:
lumpectomy + radiation VS mastectomy

A

overall survival rate is the same

47
Q

regrowth of CA cells at original site

A

local recurrence

48
Q

3 types of recurrence

A

local
regional
metastatic

49
Q

cancer cells travel from original site to settle in nearby nodes

A

regional recurrence

50
Q

CA cells from the original site have traveled to distant parts of the body

A

metastatic recurrence

51
Q

lymph nodes in armpit area; level 1,2,3

A

axillary nodes

52
Q

lymph nodes above the clavicle

A

supraclavicular nodes

53
Q

lymph nodes located along the breastbone

A

internal mammary node

54
Q

located on chromosome 17
30% of hereditary cases
increase risk of ovarian CA
increase in developing a CA in opposite breast
men have 3x the risk for prostate CA

A

BRCA 1 gene mutation

55
Q

located on chromosome 13
15% of hereditary cases
increase risk of other cancers
males have increased risk for B CA

A

BRCA 2 gene mutation

mammo (13 decks)

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