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Flashcards in breast cancer Deck (31)
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1
Q

what is the most common basis for lawsuits involving breast CA

A

delayed diagnosis

2
Q

what are some factors that inc risk of breast CA

A

> 65yrs, Bx confirmed atypical hyperplasia, inherited genetic mutations BRCA1,2, mammographically dense breast, 2 or more 1st deg relatives

3
Q

what are the 2 standard views for mammography

A

craniocaudal (CC), mediolateral oblique (MLO)

4
Q

if there is suggestion of a nodule what views would better evaluate

A

spot compression, for medial- cleavage view, magnification, additional views

5
Q

according to american college of radiology BI-RADS classification at what lvl do you have a suspicion of malignancy

A
4A (0-4A,B,C,-6)
0=needs additional imaging
4A=low;B=intermediate;C=moderate concern for malignancy
5=highly suggestive-refer to surgeon
6=known Bx proven malig-axn
6
Q

in a young pt with inconclusive MMG results with dense breast what imaging modality would you use

A

Ultrasonography- better differentiates between solid and cystic mass- can guide core needle Bx

7
Q

what diagnostic test is not recommended for eval of breast mass

A

MRI- used for staging

IV gadolinium dye- check renal fxn

8
Q

when would you use a fine needle aspiration Bx

A

low probability of CA, determine if cyst

9
Q

when is a core needle Bx used

A

if you need samples from larger solid breast mass

10
Q

T/F in the US 12% of women will develop invasive breast CA

A

true! 1 in 8

11
Q

what type of noninvasive (in situ) breast carcinoma is treated as a malignancy for potential to develop into invasive CA

A

DCIS

12
Q

how does DCIS present

A

clustered pleomorphic calcifications on MMG, 80% non palpable, ill defined mass on US

13
Q

how do you treat DCIS

A

breast conserving therapy c/ radiation, sentinel node Bx, hormone therapy if ER and PR + (Tamoxifen, Arimidex)

14
Q

what is the most common INVASIVE breast malignancy

A

ductal- 80%

commonly palpable mass or MMG abnormality

15
Q

5-10% of all invasive breast malignancies, does not form microcalcifications, more apt to be bilteral

A

Lobular

16
Q

various presentations - unilateral erythematous, scaly, weeping “eczema” that involves the nipple
discoloration/ desquamation of nipple and areola-

A

Paget dz of breast - may also present c/ bloody discharge, pain, burning, pruritis

17
Q

pain c/ rapidly progressing, tender, firm, enlarged breast, peau d’ orange, erythema

A

inflammatory breast CA- almost all involve lymph nodes- 1/3 mets

18
Q

what is the difference between radical and modified radical mastectomy

A

modified spares pectoralis

19
Q

what is brachytherapy

A

seed or wire in or near tumor- shorter duration of tx

20
Q

T/F estrogen receptor (+) breast CA is more responsive to endocrine therapy than ER (-)

A

true

21
Q

what is a targeted treatment for Her2/neu overexpression

A

herceptin

22
Q

breast CA lymph mets to

A

axillary, internal mammary, supraclavicular nodes

23
Q

hematogenous mets to

A

lung, liver, bone, ovaries, brain

24
Q

T/F BRCA 1 has 44-78% risk of breast CA by 70yrs

24-40% ovarian CA

A

true

25
Q

T/F BRCA 2 has a lower risk for breast CA in males than BRCA1

A

false- BRCA2 is higher

26
Q

at what age does everyone agree to screen for breast CA

A

50-69yrs

27
Q

according to ACS MRI screen should be done

A

BRCA mutation or Fhx, Hx of chest radiation

28
Q

how often should you follow up breast CA

A

Hx and PE q 3-6mo x 5yrs; then annualy

29
Q

if previous mastectomy how often should you screen other breast

A

annually

30
Q

chemoprevention >35yrs no prior Dx of breast CA- but increased risk

A

if premenopause- tamoxifen

post- arimidex, raloxifene

31
Q

what are the risks ass c/ tamoxifen, arimidex, raloxifene

A

inc DVT and endometrial CA