Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHAM02 > Wk 14: Breast cancer in practice > Flashcards

Wk 14: Breast cancer in practice Flashcards

1
Q

What is the strongest risk factor for breast cancer?

A

Family history - 1st degree = 2-3x higher risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the risk factors of breast cancer?

A
  • Age
  • Previous breast cancer
  • High breast density
  • Exposure to radiation
  • Inc estrogen exposure: Late meo, COC/HRT, nulliparous, never breastfed
  • Higher social status
  • White
  • Low physical activity
  • Obesity
  • Alcohol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is breast cancer diagnosed?

A

Triple assessment:

  • Clinical examination: characteristics of lump, skin changes, fluid leaking, nipple inversion
  • Breast imaging: mammography + ultrasound
  • Pathological evaluation: biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the first line treatment for breast cancer?

A

Surgery - removes primary breast tumour

  • Breast conserving surgery/lumpectomy
  • Mastectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which patients are not suitable for surgery?

A
  • Prior radiotherapy
  • Widespread disease
  • Tumours >5cm
  • Persistent pathological margin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is involved in radical mastectomy?

A

Removal of breast, pectoralis major + minor muscles + axillary contents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is involved in conventional mastectomy?

A

Removal of breast (skin + nipple), pectoral muscle maintained unless tumour invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a frequent site of lymph node metastases?

A

Axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is an axillary procedure?

A

Obtain lymph nodes for examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does lymphoedema occur?

A
  • Surgery/radiotherapy cut off lymph nodes causing fluid build up
  • Metastatic disease in axilla
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of lymphoedema?

A

Arms stiff, uncomfortable + tight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you treat lymphoedema?

A

Compression stocking + massages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What readings do you take in a patient with lymphoedema?

A

Blood + BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When do you use radiotherapy?

A
  • Patients undergone breast conserving surgery
  • After surgery for early BC
  • Combined w/ systemic therapy + surgery for locally advanced cancer
  • Combined w/ systemic therapy for metastatic disease
  • Post mastectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the early adverse effects of radiotherapy?

A
  • Skin in treatment area: sensitive, red + swollen
  • Fatigue
  • Hairloss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the late adverse effects of radiotherapy?

A
  • Breast changes: smaller + harder
  • Bone damage
  • Cardiac + respiratory toxicity
17
Q

When do you start adjuvant chemotherapy?

A

W/in 31 days of surgery or earliest date

18
Q

What needs to be considered before starting adjuvant chemo?

A
  • Nodal involvement
  • Oestrogen receptor status
  • HER 2 status
19
Q

What is the regime for node negative patients?

A

Anthracycline containing regime:
- EC (Epirubicin / Cyclophosphamide) x 6

  • FEC (5FU/Epirubicin/Cyclophosphamide) x6

Alt:
- Classical CMF (Cyclophosphamide/Methotrexate/5FU

20
Q

What is the regime for node positive patients?

A

Taxane containing regime:
- FEC-T (5FU/ Epirubicin/ Cyclophosphamide – Docetaxel)

Alternative:
- TC (Docetaxel+Cyclophosphamide)

21
Q

When is neoadjuvant chemo used?

A

Locally advanced disease:

  • ER, PR + HER2 determined prior
  • FEC/EC 4-6 cycles
  • FEC-T if node involvement
22
Q

What is used for hormonal regulation and estrogen receptor overexpression?

A
  • Tamoxifen
  • Aromatase inhibitors
23
Q

What are the side effects of hormonal therapy?

A
  • Bone loss: bisphosphonates
  • Menopausal symptoms: hot flushes, vag bleed, red libido, mood changes
  • Inc venous thromboembolism (tamoxifen)
24
Q

What is HER2?

A

Human Epidermal Growth Factor Receptor 2

25
Q

HER2 amplification is associated with what?

A
  • Accelerated cell growth + proliferation
  • Inc risk of recurrence
  • Shortened survival
26
Q

What is used to block HER2 receptors?

A

Trastuzumab - herceptin (monoclonal antibody)

27
Q

What are the adverse effects lf trastuzumab?

A
  • Neutropenia
  • Anaemia
  • Thrombocytopenia
  • Hypersensitivity reaction
  • Cardiovascular disease
28
Q

What is given for metastatic disease patients who are hormone receptor positive?

A

Endocrine 1st line:

  • Premenopausal – tamoxifen + ovarian ablation
  • Postmenopausal – aromatase inhibitor
29
Q

What is given for metastatic disease patients who are HER2 positive?

A

Targeted therapy w/ chemo:

  • Herceptin + pertuzumab + taxane
  • Herceptin + taxane
  • Herceptin monotherapy
30
Q

What is given to metastatic disease patients who are HER2 negative + hormone receptor negative?

A

Chemo

31
Q

What is the common site for metastatic disease?

A
  • Bones: ribs, spine, pelvis, arms + legs
  • Cause: pain, impaired mobility, pathological fractures + hypercalcaemia
32
Q

What is the treatment for bone metastasis?

A

Bisphosphonates or denosumab

33
Q

What is the treatment for brain metastases?

A
  • Surgery
  • Whole brain radiotherapy
  • Palliative: steroids red swelling
34
Q

What are other common sites of metastatic disease + what are the treatments?

A
  • Liver + lungs
  • Systemic therapy, surgery + radiotherapy
35
Q

What is ulcerating/fungating disease?

A
  • Cancer grows upwards + breaks skin, in shape of fungus
  • Develops if cancer untreated
  • Painful, itchy + affect movement
  • Treatment: wound management + antibiotics

PHAM02 (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions