Treatment Options

Question 1

Give the three main breast cancer treatment options.

Answer 1

Surgery, radiation, drugs

Question 2

In a discussion of breast cancer, what is a stage?

Answer 2

A process of classifying the cancer and placing it into five stages depending on the extent of the primary tumor, regional lymph node involvement, and/or distant metastasis.

Question 3

What is the difference between a modified radical mastectomy and the lumpectomy?

Answer 3

Modified radical mastectomy removes the entire breast, including the nipple/areola and some under-arm lymph nodes. Lumpectomy removes only the tumor and surrounding margins.

Question 4

Lumpectomy is often combined with what two other treatment options?

Answer 4

Radiation therapy and/or chemotherapy and/or HRT

Question 5

How long does the average radiation therapy treatment last?

Answer 5

External beam radiation typically runs 5-7 weeks

Question 6

What are the two main methods used to deliver radiation therapy?

Answer 6

External and internal beam radiation

Question 7

Give two advantages and two disadvantages of brachytherapy.

Answer 7

a. Advantages: Reduce treatment time, fewer skin reactions
b. Disadvantage: Not enough clinical trial or controlled studies, dose falls rapidly from source, specific areas around the lesion may not get a high dose of radiation.

Question 8

Why is chemotherapy considered a systemic form of treatment?

Answer 8

The drug is distributed throughout the entire body and will affect all tissues and organs.

Question 9

Identify four uses of chemotherapy.

Answer 9

Stop or slow the spread of cancer to other parts of the body, to kill cancer cells, and to relieve symptoms of cancer.

Question 10

Why does chemotherapy cause a low blood cell count.

Answer 10

Chemotherapy affects the bone marrow that makes blood cells.

Question 11

What is the main use of Tamoxifen?

Answer 11

For estrogen receptor positive cancer, tamoxifen blocks estrogen to the cancer therefore lowering the risk of recurrence.

Question 12

Name the breast cancer treatment that combines a light source and a photosensitizing agent.

Answer 12

Photodynamic therapy

Question 13

What is the main effect of antiangiogenesis drugs in cancer treatment?

Answer 13

They prevent the growth of new blood vessels necessary for cancer spread.

Question 14

Identify the technique that does not involve microsurgery whereby skin, fat, and blood vessels plus at least one abdominal muscle is moved from the abdomen to the chest area as a breast mound.

Answer 14

TRAM flap

Question 15

A radiation treatment that typically lasts 5-9 days is termed:

Answer 15

Brachytherapy (internal) 5-9 days vs. Teletherapy (external) once a day x 6 to 7 weeks

Question 16

Of the following, which is the most breast conserving surgery?
A. chemotherapy
B. mastectomy
C. modified radical mastectomy
D. lumpectomy

Answer 16

Lumpectomy, it removes the lesion and surrounding margins.

Question 17

Side effects of chemotherapy include:

1. nausea or vomiting
2. reduced white cell count
3. increased red cell count

Answer 17

1 and 2- Chemo affects all the organs and tissues of the body. Blood cell count, red, white and platelets will fall and chemotherapy effect on the cell lining the gastro-intestinal track can cause nausea and vomiting.

Question 18

If the margins of a specimen are positive, then
A. all cancer has been exhausted
B. additional tissue must be exercised
C. lumpectomy was the wrong treatment option
D. the patient will have to undergo a mastectomy

Answer 18

B. While removing a lesion the surgeon must ensure that all margins are clean. A positive margin indicates that all the cancerous cells have not been removed and the surgeon will have to remove more tissue.

Question 19

Neoadjuvant chemotherapy refers to treatment
A. before surgery that utilizes anti estrogen drugs
C. before surgery t help shrink the size of the cancerous tumors
D. after surgery that involves radiation

Answer 19

C. Neoadjuvant treatment is given before surgery to help shrink the size of the cancerous tumor. Adjuvant chemotherapy is given in addition to another cancer treatment.

Question 20

The benefits of tamoxifen are negligible after \_\_\_\_\_\_\_years
A. 2
B. 3
C. 4
D. 5

Answer 20

D. The benefits of Tamoxifen are only considered effective within a 5-year period.

Question 21

What is tamoxifen?

Answer 21

Tamoxifen is an anti-estrogen drug used to block estrogen from latching to the cancer receptor cells.

Question 22

Advantages of brachytherapy (internal radiation) include all of the following except:
A. reduced time of treatment
B. less irritation of healthy breast tissue
C. longer delays before the start of treatment
D. fewer skin reactions

Answer 22

C. Brachytherapy is a method in internal radiation therapy. With Brachytherapy, the big-energy radiation beam is concentrated on the cancerous tissue sparing the surrounding normal tissue. This allows reduction in treatment time,less irritation of normal tissue and fewer skin reactions.

Question 23

Reconstructing the breast to remove tissue is a technique that involves relocating the nipple is called:
A. augmentation mammoplasty
B. reduction mammoplasty
C. core biopsy
D. ductography

Answer 23

B. In reduction mammoplasty, the oversize of the breast is reduced. Augmentation will increase breast size. The core biopsy removes tissue sample for analysis and ductography is a check of the larger ducts.

Question 24

The removal of tissue and muscle from the abdomen to reconstruct a breast mound using microsurgical techniques is called
A. latissimus dorsi flap
B. pedicle flap
C. TRAM flap
D. Free flap

Answer 24

C. The TRAM flap is the transverse rectus abdomens myocutaneous muscle flap where tissue and muscle from the abdomen is reconstructed to make a breast mound.