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19 Cards in this Set
- Front
- Back
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Define staging for breast cancer.
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0 - confined to lobular and ductal cells
1 - small tumor, no lymph node involvment 2 - small tumor - localized nodal involvment 3 - large tumor - extensive nodal involvment 4 - metastatic |
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Define the risk levels of breast cancer.
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Low risk; node (-), tumor > 2cm, no vascular invasion, HER2 (-), > 35 yrs
Intermediate risk; node (-), tumor < 2cm, vascular invasion, HER2 overexpression, < 35 yrs High risk; 1-3 nodes (+), HER2 (+) |
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Surgery is best for?
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low risk only
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What do the following treatment initials stand for?
TAC FAC CMF |
TAC - docetaxal, doxorucicin, cyclophosphamide
FAC - 5FU, doxorubicin, cyclophosphamide CMF - cyclophosphamide, methotrexate, 5FU |
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whats classes of drugs are the most active in breast cancer?
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anthracyclines and taxanes
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What is Herceptin (trastuzumab)?
contradictions? |
a biologic that is a monoclonal antibody against HER2
do not give with anthracyclines, cardiotoxicity |
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What are goals of endocrine therapy?
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decrease circulating levels of estrogen; decrease estrogen response at HR
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What are two SERMS?
how long and who are they for? |
tamoxifen and tamorifen
take 5 yrs after therapy pre and post menopausual women |
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What are the three LHRH agonists?
indications |
goserlin, leuprolide, triptorelin
premenapausal |
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What was the estrogen receptor antagonist?
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fluvestrant
postmenapausal women |
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What are some risk factors associated with breast cancer?
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family history of BRCA1 and BRCA2, early menarche < 12 yrs, later birth > 30, lifestyle
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What can be good prevention?
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prophylactic mastectomy, chemoprevention (raloxifen, tamoxifen), modify lifestyle
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DRAW early breast cancer algorithm
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see notes 27
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DRAW locally advanced algorithm
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see notes 38
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if hormonal and chemotherapy are going to be used which is used first?
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chemo
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What is letrazole?
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a nonsteroidal aromatase inhibitor used in combination with trastuzumab
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what are the stipulations on trastuzumab combinations?
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may combine with chemo and hormone thereapy unless an anthracycline is being used.
If anthracyclines are being used then wait till that therapy is over before beging trastuzumab |
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What has been proven to be just as effective if not more effective than chemo in premenopausal women?
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LHRH agonists goserelin
can also add tamoxifen to be even more aggressive |
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what happens if a pt originally responds to hormonal therapy but then relapses?
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can still try hormonal therapy, just use medication with different MOA
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