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33 Cards in this Set
- Front
- Back
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Describe an excisional biopsy and when to use it.
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Use for a palpable mass, when no doubt of where to cut
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Describe a wire-assisted biopsy.
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Abnormal mass on image but not palpable
Wire is radiographic and helps to take it out |
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Describe Stereotactic Methods
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Utilize a computer and imaging during excision to remove/biopsy the mass
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If the biopsy is positive, you clinically stage it via TNM system. What does TNM stand for?
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T: size of the primary tumor
N: involvement of lymph nodes M: presence of distant spread of metastisis |
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What is the most crucial aspect of the TNM system in regards to breast cancer?
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The N, lymph nodes, determine much of the severity and route of treatment
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What does Ts mean?
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Carcinoma in situ: intraductal, lobar or piaget's
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Define T1-T4 tumor sizes
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T1<2cm
T2>2cm T3>5cm T4 extends into chest wall or skin |
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Define the different levels of N.
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No: no regional node mets
N1: mets to ipsilateral axillary nodes (movable) N2:Mets to ipsilateral axillary nodes (fixed) N3: mets to ipsilateral internal mammary nodes/beyond |
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Define the M, metastisis category.
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M0: no distant mets
M1: distant mets (including ipsilateral supraclavicular nodes) |
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Sentinel lymph node (SLN) biopsy is an analysis method for...
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...patients with negative lymph nodes to identify migration of tumor cells
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Name the 5 General Treatment Strategies of BC.
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1. Surgery
2. Radiation 3. Chemo 4. Hormone Therapy 5. Biologic Therapies |
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What is the goal of surgery?
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Remove, Debulk
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Surgical breast treatment includes:
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Lumpectomy and Masectomy
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Surgical Nodal Treatment includes:
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Axillary dissection and Sentinel Node Sampling
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What are the benefits of Masectomy?
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One Surgery
Recover< 1 week USUALLY no radiation needed |
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What are the disadvantages of mastectomy?
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Long recovery
Emotional/Sexual issues/Cosmetic |
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What is the advantage of a lumpectomy?
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Preserve Boob
Quick Recovery Avoid Cosmetic issues |
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Disadvantages of a lumpectomy?
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MUST have radiation
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What is the treatment goal of RADIATION?
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Target cell DNA to destroy
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Describe Radiation (3)
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Megavoltage radiation
Needed everyday for 6-7 weeks after surgery |
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Name the treatment goal of Chemo.
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Use toxins targeted to kill rapidly dividing cells
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What are common Side Effects of Chemo?
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Fatigue
Nausea Diarrhea Hair Loss Weight Loss Depression Surpessed Immune system |
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What are complications of Chemo?
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Infection
Bleeding Secondary Cancers (Leukemia) |
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What is the treatment goal of Hormone Therapy?
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Interfere with the tumors access to hormones needed to grow and thrive (systemic)
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What is the DOC to prevent secondary cancers?
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Selective Estrogen-Receptor Modulators (SERM's) like tamoxafin
Used for 5 years after surgery Increases risk of endometrial cancer and DVT/PE |
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Which BC drug class do you use ONLY in post-menopausal women?
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Aromatase Inhibitors
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What is the treatment goal of Biologically Targeted Therapies?
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Specific targeted antibodies
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State the 3 main facts about a breast cancer survivor's risk of reoccurrence.
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1. related to extent of disease: tumor size and nodes
2. may reoccur 20-40 years after Dx 3. Lowest risk is with tumors<1cm and no nodes |
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State the 3 main facts about a breast cancer survivor's risk of second primary malignancy.
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7-8% chance of development in contralateral breast
Lower this risk with SERM's Slight increased risk of colon and ovarian cancer |
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What are a survivors' risk of complications of Tx? (6)
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Secondary Malignancy (endometrial or sarcoma)
Ovarian failure/menopause (with SERM and cytotoxic agents) Lymphedema CV toxicities Brachial plexopathies Venous/arterial thrombosis |
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How often do you follow up with survivors?
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Every 3 months for the first 3 years
Every 6-12 months for 2 more years Then yearly |
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How often should a survivor get a mammogram and pelvic exam?
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Yearly
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How often should a survivor do a self-breast exam?
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Every month
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