Flashcards in Breast 3 Deck (14):
stage 0 and stage 1 breast cancer with tumor <1 cm?
Stage 1 cancer with 1-2 cm tumor?
For stage 2 cancer?
Lumpectomy, axillary sampling, radiation therapy (if ER positive, add hormone therapy)
Lumpectomy, axillary sampling, radiation therapy, and adjuvant therapy (hormonal or chemo)
Modified radical mastectomy, axillary sampling, radiation therapy, Agilent therapy
Which breast cancer patients get chemotherapy?
All patients with node positive disease and all premenopausal women
Follow-up for postoperative breast cancer patients?
Two visits a year with CXR and LFTs
If had lumpectomy, mammogram every six months for 2 years
Management for stage III cancer? Stage IV cancer?
Neoadjuvant chemotherapy before surgery
Palliative radiation and chemotherapy. Surgery only for local control of primary tumor
Histopathology of the suspected breast tumor shows cancer cells invading dermal lymphatics and vessels – diagnosis?
Five years post breast cancer surgery, patient presents with elevated LFTs – suspect? Tests?
Suspect metastasis to the liver. Contrast enhanced CT scan of the abdomen
if poor renal function MRI with gadolinium enhancement
Five years post breast cancer surgery, Patient presents with a femur fracture – suspect? Next steps?
Pathologic fracture secondary to metastasis
Orthopedic repair, Local cancer control with irradiation
Five years post breast cancer surgery patient develops decreased sensation and motor function in the right leg – Suspect? Management?
Extradural metastasis to the spine. MRI, steroids, cord decompression and radiation
Five years post breast cancer surgery presents with new onset seizures and focal findings – suspect? Management?
Metastasis to the brain – CT/MRI followed by steroids and surgery/irradiation
Five years post breast cancer surgery, presents to emergency department with coma/confusion and no focal findings – suspect?
Acute hypercalcemia due to bony metastasis or parathyroid related peptide
Breast-feeding mother develops painful breast, low-grade fever, and red, tender, indurated breast mass and shotty nodes – differential and treatment?
1. Mastitis – warm compress, antibiotics
2. Abscess – open surgical drainage
Breast-feeding mother develops painful breast, low-grade fever, and red, tender, indurated breast mass and shotty nodes – Does not respond to multiple different antibiotics – suspect?
Inflammatory carcinoma – get biopsy
Changes in treating breast cancer in pregnancy?
1. Postpone radiation until after delivery (so discourage lumpectomy in early pregnancy because of the need for radiation)
2. Chemotherapy after the first trimester