Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
11 Cards in this Set
- Front
- Back
|
Define prognostic versus predictive
|
Prognostic: Determines populations at risk of recurrence
Predictive: Determines patients who may benefit from specific types of systemic therapy (which tx will work best) |
|
|
8 tumor characteristics used to define disease/predict risk of recurrence
|
Tumor Size
Nodal Involvement Hormone Receptor HER2 Status Histologic Grade Proliferative Rate Vascular Invasion Response to Primary Therapy |
|
|
When staging how does one define primary tumor size?
|
T0 = no evidence of primary tumor
T1 = 2cm or less T2 = >2-5cm T3 = >5cm T4 = tumor of any size with extension into the chest wall and/or skin |
|
|
When staging how does one define nodal involvement?
|
N0 = No nodal involvement
N1 = 1-3 positive lymph nodes N2 = 4-9 positive lymph nodes N3 = 10+ positive lymph nodes |
|
|
Is the presence of hormone receptors more predictive or prognostic?
|
Preditive
Patients who are estrogen AND progesterone positive have a lower recurrence rate with tamoxifen than patients who are estrogen positive and progesterone negative |
|
|
How does HER2 status affect chance of recurrence and treatment options?
|
HER2 positive cancers are more agressive and have a higher response rate
Relatively resistant to endocrine therapy alone and respond better to an aromatase inhibitor Resistant to CMF (cyclophosphamide, methotrexate, fluorouracil) Respond best to anthracycline, taxane and trastuzumab (Herceptin) |
|
|
What's the mechanism of action of Herceptin?
|
Trastauzumab targets the extracellular domain of HER2
|
|
|
What type of breast cancer is not assigned a histologic grade?
|
Medullary carcinomas
|
|
|
3 types of breast cancers have a more favorable prognosis compared with 4 other and unknown types.
|
Tubular, mucinous and medullary subtypes have a more favorable prognosis compared with ductal, lobular, mixed, metaplastic and unknown types.
|
|
|
How is a histologic grade assigned?
|
Grade is determined by assessing the miotic index, differentiation and pleomorphism of cells. Well differentiated cells are assigned a more favorable grade of 1 than poorly differentiated cells (3)
|
|
|
What are two proliferation markers? When is it useful to assess their presence?
|
Cyclins (particularly women with high concentrations of cyclin E) have reduced 5 year disease-free survival and overall survival rates.
Ki-67 may also correlate with reduced survival rates. These are not assessed routinely but may be helpful in predicting recurrence in women with borderline tumor sizes and LN negative disease. |
