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59 Cards in this Set
- Front
- Back
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What is the most common cancer in women? |
Breast Cancer |
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What is the leading cause of death in women ages 45-55? |
Breast Cancer |
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Which cancer is the second most common cause of cancer deaths in the US? |
Breast Cancer |
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What are the primary risk factors of breast cancer? |
-Female -Age > 50 -North American/North European ancestry -First degree relative with breast cancer BRCA 1 or BRCA 2 mutation |
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What are the secondary risk factors of breast cancer? |
-Postmenopausal obesity -Menarche before age 12 -Menopause after age 55 -First FT pregnancy after 30 years -OC use < 20 years old, for 6+ years -Benign breast disease -ETOH -Diet |
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Are most breast cancers correlated with a family history? |
-23 % family history -Most breast cancers are sporadic |
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What are the BRCA 1 and BRCA 2? |
Breast/ovarian susceptibility gene |
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How strong is the likelihood that the BRCA 1 and BRCA 2 mutation will result in the development of disease? |
-85% risk of developing breast cancer by age 70 -26%-85% Ovarian (BRCA1) 10% (BRCA2) |
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What lifestyle modification can help decrease the risk of breast cancer? |
-Weight management -Limit alcohol intake -Limit animal fat -Antioxidants -Exercise (reduces free estrogen stored in fat) |
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How often does the ACS recommend breast cancer screening? |
-Annual mammogram beginning at the age of 40 or 45 -Mammogram starting every other year starting at the age of 55 -Consider MRI for high risk patients (>25%) |
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What are the diagnostic tests for breast cancer? |
-Clinical exam -Mammography -Ultrasound -CT -MRI -PET -Biopsy |
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Patients with a BIRADS score of ________ can be seen only once a year? |
1- Normal 2- Benign |
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Patients with a BIRADS score of _______ need to be seen every 6 months |
3- Probably Benign |
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Patients with a BIRADS score of ______ need to have a follow up biopsy |
4- Suspicious abnormality a, b, c |
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Patients with a BIRADS score of _______ have a 95% chance of cancer. |
5- Highly suspicious of malignancy |
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Patients with a BIRADS score of ______ may need to have a follow up ultrasound. |
0- Needs further imaging or comparison |
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Patients with a BIRADS score of ______ already have a known malignancy. |
6- Known malignancy |
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List the characteristics of a low risk breast mass |
-Smooth -Round -Movable -Well-circumscribed on mammo -Cyst on ultrasound |
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List the characteristics of a high risk breast mass |
-Stoney-hard lump -Fixed -Skin changes -Bloody nipple d/c -Spiculation/Ca++ on mammo -Complex/solid on ultrasound |
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What is the use of a percutaneous fine needle aspiration (ultrasound guided or palpation) |
Smaller needle is often used to see if Ca spread to lymph nodes |
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What is the use of a percutaneous core needle biopsy (MRI, stereotactic or US guided) |
Larger needle is often used for pathology of a new cancer diagnosis |
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What is the preferred method of surgical biopsy |
-Excisional biopsy Incisional is avoided to prevent opening and spreading tumor |
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List the types of breast cancer |
-Carcinoma in Situ (CIS): lobular, ductal, pagets disease -Infiltrating Ductal -Infiltrating lobular -Medullary -Tubular -Inflammatory -Sarcoma of the breast |
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What are the characteristics of breast CIS |
Cancer is confined to ducts or lobules -no invasion of surrounding fatty tissues -no spread to other organs Ductal (DCIS) -"nonmalignant breast cancer" -Very common Lobular (LCIS) -Tumor marker: not a cancer |
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Ductal CIS Clinical Presentation: |
-Calcifications on mammo -Noninvasive -Invasive potential based on grade -Associated with a good prognosis |
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Lobular CIS Clinical Presentation: |
-Usually an incidental finding -Screening difficult -Usually not seen on mammo -Tumor marker (7 to 11 fold increase of invasive cancer) |
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Infiltrating Ductal (IDC) characteristics |
-Most common type of breast cancer -Begins within a breast duct -Invades the cellular basement membrane -Infiltrates the wall of the duct into the fatty tissue -Can spread through lymphatic circulatory system |
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Infiltrating Ductal (IDC) Clinical presentation |
-Palpable or not -Mammo abnormal - -Mass with or without calcifications - -Spiculated appearance on mammo - Metastatic potential |
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Infiltrating Lobular (ILC) characteristics |
-Mostly palpable on presentation -Occasionally no mammo abnormality to correspond to palpable mass -Begins in the milk-producing glands -Can spread beyond the breast -Accounts for 5-10% of invasive breast cancers -Metastatic potential |
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Infiltrating Lobular (ILC) clinical presentation |
-5-10% occurrence -Diffuse, ill defined mass -Multicentric -Bilateral -Nodal metastasis common |
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Characteristics of inflammatory breast cancer |
-1% of invasive breast cancers -Sudden onset - Often confused with mastitis -Inflamed appearance due to the rapid spread of cancer cells within lymphatic channels of the skin -Stage 3B/4 (with distant spread) -Breast cancer emergency! |
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Inflammatory breast cancer clinical presentation |
-Erythema - Heat - Peau d' Orange - Edema - Skin ulceration - Isolated skin nodules |
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Clinical staging/Pathological Staging of breast cancer is based on what factors? |
-Primary tumor -Physical examination of the axillary nodes -Presence or absence of distant metastases |
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Local, Regional Breast Disease are given what stages? |
-Stage 0 -Stage 1 -Stage 2A |
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Locally Advanced Breast Disease, or Recurring Disease are given what stages? |
-Stage 2B -Stage 3A -Stage 3B -Stage 3 C |
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Metastatic Breast Disease is what stage? |
Stage 4 |
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Quantity and duration of which activity will increase a patients risk for lung cancer? |
Smoking |
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List some occupational and environmental risk factors for lung cancer |
-Secondhand smoke -Asbestos -Certain metals/Natural gases: Radon, Uranium, Arsenic and Bis-chloromethyl ether |
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What percentage of cancer could be prevented by modifying or avoiding key risk factors? |
30% |
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What is the recommended screening test for lung cancer? |
CT (x-ray is too late, cancer is too large by the time they show on x-ray) |
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What are the prevention strategies for lung cancer? |
-Behavioral -Chemoprevention |
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What are the risk factors for lung cancer? |
-Smoking -Occupation and Environmental Factors -Genetic Susceptibility and Family History |
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What are the two main types of lung cancer? |
1) Small Cell Lung Cancer (SCLC) - - - 15% of cases 2) Non-Small Cell Lung Cancer (NSCLC) - - - 85% of cases |
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What are the types of Non-Small Cell Lung Cancer? |
1) Squamous Cell Carcinoma 2) Large Cell Carcinoma 3) Adenocarcinoma |
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What are the characteristics of Squamous Cell Carcinoma? |
-25-30% of all cases of lung cancer -Often linked to smoking -Typically located near central region of lungs |
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What are the characteristics of Large-Cell Carcinoma? |
-10-15% of all cases of lung cancer -Typically located in peripheral regions -Tend to grow and spread quickly |
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What are the characteristics of Adenocarcinoma? |
-40% of all cases of lung cancer -Typically located in peripheral regions -Includes BAC (bronchoalveolar Lung Cancer) or now classified as Lepidic Predominant Adenocarcinoma |
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What are the characteristics of Small Cell Lung Cancer? |
-Rapid Doubling Time -High Growth Fraction -Early Widespread Metastasis -Limited Stage 30% of patients - - Tolerable in radiation treatment field -Extensive Stage 70% of patients - - Bilateral lung usually -Often presents with metastasis |
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What is the clinical presentation of Small Cell Lung Cancer? |
-Large Hilar Mass -Bulky Central Adenopathy -Uncommonly a peripheral nodule -Paraneoplasia |
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Paraneoplasia in Small Cell Lung Cancer |
-ACTH -ADH -Neuropathy -Myasthenic Syndrome -Encephalomyelitis |
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Symptoms of Small Cell Lung Cancer |
-Coughing, wheezing, hoarseness -Fatigue -Sputum streaked with blood -Shortness of breath -Pain in chest, shoulder, upper back -Recurrent pneumonia or bronchitis -Loss of appetite and weight |
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What is Limited Stage Small Cell Lung Cancer? |
Cancer is found in only one lung, tissues between the lungs and nearby lymph nodes |
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What is Extensive Stage Small Cell Lung Cancer? |
Cancer has spread outside the lung in which it began |
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What are the treatment options for Non-Small Cell Lung Cancer? |
-Surgery -Radiation Therapy -Chemotherapy -Targeted Therapy -Immunotherapy |
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What are the surgical options for Non-Small Cell Lung Cancer? |
-Lobectomy -Pneumonectomy -Segmentectomy/Wedge -VATS |
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What are the radiation options for Non-Small Cell Lung Cancer? |
-Definitive/Radiosurgery/Brachytherapy -Pre-operative -Post-operative -Combined Modality -Palliative -Radiofrequency Ablation -Laser -Photodynamic |
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What are the chemotherapy options for Non-Small Cell Lung Cancer? |
-Neoadjuvant -Adjuvant -Definitive -Combined Modality -Palliative |
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What are the targeted therapy options for Non-Small Cell Lung Cancer? |
-EGFR -VEGF -ALK -ROS1 |
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What are the immunotherapy options for Non-Small Cell Lung Cancer? |
-Ipilimumab -Nivolumab -Pembrolizumab -Atezolizumab |
