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35 Cards in this Set

  • Front
  • Back
what are the RF of breast cancer
increasing age >60
genetic especially when <45 there is a 1.5-3 x increase
alterations BRCA
HER2neu
hormonal no preg, late menopause, early menarche, physical inactivity, obesity, alcohol
what makes a better chance of not contracting breast cancer
late period, early menopause
how is alcohol a RF for breast cancer
it increases estrogen from increased folic acid
how do you screen for breast cancer
self every month after year 20 right after period
clinically q 3 yrs 20-39 and q year anually 40+ yrs
mammogram anually 40+
how can you prevent breast cancer
surgery in high risk if benefits>risks
- tamoxifin
what are types of invasive breast cancer
ductal
lobular
inflammatory breast
how can you tell if it is ductal invasive cancer
prominent unilateral lump
how can you tell it it is lobular invasive breast cancer
thickening of breast
how can you tell if it is inflamm breast cancer
skin edema, redness, warmth
what the types of non-invasive breast cancer
ductal carcinoma insitu
and lobular carcinoma in situ
how can you tell it is non-invasive ductal carcinoma in situ
small non-palpable lesions
how can you tell it is non-invasive lobular corcinoma in situ
non-gross abnormality
how do you determine tumor size
1 is <2cm, 2 is >2 cm <5cm, T3 is >5 cm
how do you determine number of luymph nodes
N1 - 1-3 axiallary, N2 - 4-9 axiallary or mammery, N3 - >10 axiallary, intraclavivular, supraclavicular
what stage is metastasis
stage 4
what is the stage for carcinoma in situ
stage 0
what are the biomarkers and what do they say about the cancer
ER/PR +, means less aggressive
what does HER2/neu positive mean
more aggressive
what do you treat with HER2/neu positive
trastuzumab
what is the treatment of stage 0,1,2,
goal is to cure with surgery, taxanes, anthracyclines, cyclo, methotrexate, or FU (best is doxo +cyclo)
what is the superior treatment fo stage 0,1,2
AC for 4 cycles followed by paclitaxel 4 cycles
what is the treatment for ER/PR+ stage 0,1,2
tamoxifen
what are aromatase inh used for
ER/PR+
what is the treatment for stage 3
neoadjuvant chemo
what is the treatment for stage 4 ER/PR+
aromatase inh
what are the ADR of trastuzumab
Black box- hypersens, cardiomyopathy
what is the MOA of trastuzumab
humanized monoclonal antibody to HER2neu receptor protein
what is the dose of trastuzumab
4mg/kg IV over 90 min on Day 1
and 2mg/kg over 30 min q week
what is the treatement for pre-menopausal woman
LHRH plus tamoxifen
what is the MOA of tamoxifen
competitively block estrogen receptor, estrogen agonist at bone, lipids, and endometrium; estrogen antagonists at breast and vaginal mucosa
what is the dose of Tamoxifen
20 mg daily
what are the ADR of tamoxifen
hot flashes, fluid ret, thrombotic events, endometrial cancer
what is the MOA of aromatase inhibitors
inhibit or inactivate aromatase - suppress plasma estrogen levels
dose for anastrazole, letrozole, exemestane
1mg, 2.5mg, 25mg po
ADR of aromatase inh
asthenia, athralgias, hot flashes, long-term osteoporosis