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19 Cards in this Set

  • Front
  • Back
What are 6 flags for hereditary breast cancer syndrome?
1. Breast CA before 50yo
2. Ovarian CA at any age along with F HX of breast, pancreas, and/or ovarian.
3. male breast CA at any age
4. multiple breast or ovarian CA
5. Ashkenazi Jewish descent
6. Bilateral breast CA
Are BRCA 1 & 2 dominant or recessive?
Autosomal dominant
Is BRCA 1 & 2 passive from mom or dad?
Can be either maternal or paternal
If you have BRCA 1, what is your chance of developing breast or ovarian CA?
Breast = 50-85%
Ovarian = 15-45%
If you have BRCA 2, what is your chance of developing breast CA?
Breast = 50-70%
35yo female with family Hx of father had male breast CA, paternal aunt had ovarian CA.

What do you do?
Have patient have a screening mammogram. And have genetic testing done on FATHER
51yo female with hot flashes, wants estrogen.

What do you tell her?
Tell her that women who have taken estrogen and progesterone have an increased risk of breast CA, stroke, and venous thrombus embolism. Also those women that got CA were more likely to have larger tumors and more positive lymph nodes.
Why does Estrogen promote CA?
Estrogen binds to the ER and causes proteins involved in growth or differentiation to be produced.
Can hormone treatments be used to prevent or treat breast CA?
YES!! SERMS (Selective estrogen receptor modulators) = Tamoxifen and Raloxifene.

In the BCPT = Tamoxifen was proven to prevent breast CA but increased endometrial CA.

Pt on Tamoxifen. How does it work?
Tamoxifen (and raloxifene)interacts with the ER as a estrogen agonist in bones and antagonist in breast and ovarian tissue (MOW).
Side effects of SERMS?
Hot flashes, reduces cholesterol, vaginal dryness, maintains bone density, increases risk of thromboembolism, and cataracts.
What is the GAIL MODEL? (6)
1. Age at present?
2. Menarche?
3. First live birth age?
4. # of first degree relatives with Breast CA
5. # of breast biopsies
6. # of biopsies that were atypical
What does Tamoxifen do to the risk of ischemic heart disease?
Who is Tamoxifen given to?
Women with a Gail risk of > 1.6% of getting breast CA in the next 5 years.
Compare Raloxifene to Tamoxifen:
Raloxifene was just as good as preventing breast CA AND showed less endometrial CA resulting than with Tamoxifen.

What do Aromatase inhibitor do?
Aromatase inhibitors:
Block aromatase enzyme in the final step of estrogen biosynthesis. And also block conversion of androgens to estrogen.

However, these are only effective in postmenopausal women.
Compare Tamoxifen and AI's in how they reduce recurrence of breast CA:
AI's exhibit a larger reduction in recurrence.
Compare side effects of AI's and Tamoxifen:
AI: more osteoporosis

Tamoxifen: more clotting events
Can AI's prevent breast CA?
Unknown, currently being studied