BRCA

Question 1

7 warning signs

Answer 1

sore that won't heal
nagging cough/ hoarseness
indigestion/difficulty swallowing
obvious change in wart or mole
thickening lump
bowel/bladder changes
unusual bleeding/discharge

Question 2

second most common cause of CA related deaths in women

Answer 2

breast CA

Question 3

if diagnosed early what percentage is the 5-year survival rate?

Answer 3

93%

Question 4

give the pathophysiology of brca

Answer 4

lobular (milk-producing glands) carcinoma
(epithelial lining ducts) ductal carcinoma
in situ (still localized, not yet broken through basement membrane)
invasive
metastatic

Question 5

most common type of brca

Answer 5

invasive ductal carcinoma

Question 6

most harmful/aggressive type of brca

Answer 6

inflammatory brca

Question 7

type of brca that has persistent lesions in breast tissue

Answer 7

Paget’s disease

Question 8

2 non-invasive brca

Answer 8

pagets dx & inflammatory breast CA

Question 9

risk factors (name drugs)

Answer 9

hormonal replacement therapy (HRT) and oral contraceptives

Question 10

risk factors (genetics)

Answer 10

family history

BRCA 1 & BRCA 2

Question 11

risk factors (age and menopause)

Answer 11

> 60 years of age

menopause before age 55

Question 12

risk factors (regarding child bearing process)

Answer 12

nulliparity (never having children)

first child born after age 30

Question 13

risk factor (regarding menarche)

Answer 13

beginning menstrual cycle before age 12

Question 14

environment risk factor for breast CA

Answer 14

radiation exposure

Question 15

modifiable risk factors for BRCA

Answer 15

sedentary lifestyle
obesity
increased fat diet
ETOH excessive intake

Question 16

common locations BRCA tends to occur (specific name)

most commonly occurs in which breast?

Answer 16

upper outer quadrant (Tail of spence)

left breast

Question 17

S&S-BRCA regarding lump in breast

Answer 17

lump in breast that's hard
irregular shaped
poorly delineated (abnormal outer edges)
fixed
non-tender
asymmetry of breasts

Question 18

S&S regarding skin & pain (3)

Answer 18

dimpled skin (small retractions) (peau d’ orange)
nipple retention
pain (late sign)

Question 19

screening for BRCA

Answer 19

self breast exam
clinical breast exam 
mammogram
MRI (if high risk)
ultrasounds

Question 20

how often should clinical breast exams be performed

Answer 20

q3yrs at ages 20-30

qyr at age 40

Question 21

how frequently should mammograms be performed?

Answer 21

qyr starting at age 40

Question 22

name 3 diagnostic tests for BRCA

Answer 22

fine needle aspiration (FNA)
Excisional (open) biopsy also called lumpectomy
sentinel node biopsy

Question 23

staging roman numeral in which it is ipsilateral (on the same side of the body) axillary lymph nodes

Answer 23

stage II

Question 24

staging in BRCA: local and encapsulated

Answer 24

stage I

Question 25

staging: contralateral axillary or mammary lymph nodes

Answer 25

stage III

Question 26

staging: distant metastasis

Answer 26

stage IV

Question 27

surgical tx (3)

Answer 27

radical mastectomy lumpectomy modified radical mastectomy

Question 28

surgical tx that involves the removal of the entire breast, all, lymph nodes, and most of pectoral muscles removed

Answer 28

radical mastectomy

Question 29

the surgical tx in which area around the tumor removed muscle and some lymph nodes spared, and may involve axillary node dissection

Answer 29

lumpectomy

Question 30

surgical tx: breast removed, muscle spared

Answer 30

modified radical mastectomy

Question 31

post mastectomy care discharge teaching

Answer 31

wash cuts stat avoid sunburns use electric razor avoid elastic cuffs/BP cuffs

Question 32

post mastectomy discharge follow-up

Answer 32

2 weeks after q2-3 month x 2 yrs q6 months x 5 yrs qyr after that

Question 33

risk of metastasis that is the most common

Answer 33

bone

Question 34

risk of metastasis: other locations other than the most common

Answer 34

liver lungs brain

Question 35

S&S of metastasis

Answer 35

``` HA/visual changes cough/SOB RUQ tenderness lumps back/bone pain ```

Question 36

adjuvant therapy

Answer 36

chemo hormonal therapy Herceptin radiation

Question 37

purpose of chemo

Answer 37

stop micro metastic spread of abnormal cells

Question 38

combination of drugs with chemo tx

Answer 38

``` cyclophosphamide (Cytoxan) doxorubicin (Adramycin) "Red Devil" 5-Fluorouracil Methotrexate paclitaxel (Taxol) ```

Question 39

hormonal therapy:purpose

Answer 39

used for tumors with estrogen receptors | blocks source of estrogen

Question 40

hormonal therapy meds:

Answer 40

tamoxifen femara trastuzumab (Herceptin)

Question 41

Tamoxifen (duration of tx, risks, S&S)

Answer 41

PO x 5yrs risk of eye damage/other CA HA, hot flushes, "menopause"

Question 42

Femara (its use and stops what?)

Answer 42

used in post-menopausal women & stops reproductivity

Question 43

Trastuzumab (Herceptin)

Answer 43

monoclonal antibody targets only CA cells with HER-2 receptors adjunct tx with chemo

Question 44

Radiation (primary or secondary?)

Answer 44

can be primary

Question 45

Radiation will be given how?

Answer 45

normally will be at a very HIGH dose

Question 46

Radiation will include what therapy?

Answer 46

brachytherapy

Question 47

what is brachytherapy

Answer 47

small radioactive seeds physically implanted in middle of tumor