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A ORAL BOARDS 2016 > BREAST > Flashcards

Flashcards in BREAST Deck (21):
1

Lesions has a risk associated breast cancer

Atypical dcutal hyperplasia

2


What are contraindications of normal chemotherapy and hormonal therapy regarding pregnancy

No methotrexate
No hormonal therapy
No breast-feeding with chemotherapy
No blue dye

3

Adverse reaction to lymphazurin urine blue dye

Anaphylaxis

4

Adverse reaction to methylene blue

Skin necrosis

5

Breast stage

draw out table

T1 less than or equal to 2 cm
T2 two – 5 cm
T3 greater than 5 cm
T4 scanner chest wall invasion

N1 one – three
N2 four – nine
N3 10 or more

Stage one:
T1 N0

Stage II:
T1 N 1
T2 N 0-1
T3 N0

6

Indication for adjuvant therapy in breast-cancer

Greater than 1 cm tumor
Node positive
Locally advanced –skin or chest wall T4

7

Indication for a neoadjuvant therapy for breast cancer

Locally advanced disease

Inflammatory

8

Contraindicated imaging studies in pregnancy for breast workup

Do ultrasound FIRST

Cranky about mammogram possibly if need more information and shield the baby

Cannot get gadolinium for MRI!

9

What adjunct of management is done for triple negative breast cancer

Give Taxane just for being triple negative

10

What breast cancer gets new adjuvant therapy

Triple negative taxne
Her 2 nu positive
Locally advanced
Inflammatory breast cancer
Clinically palpable notes

11

What needs to be included in the work up of a 38-year-old female with palpable breast mass

Genetic testing because lessen age 45!

12

How many cycles is new adjuvant therapy given

Three cycles usually Adriamycin and cisplatin Plus minus taxol

13

When is axillary radiation given

Four or more lymph nodes positive

14

What needs to be considered before doing a mastectomy

Reconstruction

15

Oncotype DX

Get this test when Her-2-nu NEGATIVE

Gives recurrence score

the popular 21-gene assay for breast cancer recurrence risk (Oncotype DX, Genomic Health) have been retrospective, so the evidence is less desirable.

less than 17 = no chemo

16

Axillary mass unknown primary

3 cm mobile

BiRAD 1

what is work up and treatment

BIRAD is increased to three because it's in the axilla!

If this is young in an unknown primary gig BRACA testing

Core needle biopsy adenocarcinoma of the axilla

Ask pathology for:
S 100 - rule out melanoma
B Raff
ER PR
Her 2 nu
CEA - rule out colon cancer


Breast MRI negative

CT scan:
Chest
Abdomen and pelvis
Head neck

If neg:
Triple endoscopy:
Frango laryngoscopy
Upper scope
Bronchoscopy

Treatment:
Modified radical mastectomy

Specimen returns 0.5 cm invasive ductal carcinoma ERP are positive

Needs chemo and XRT because axilla was positive for notes


17

Utility a frozen section with breast cancer

Almost none

(Same of melanoma and thyroidFollicular)

18

80 year old female with 3 cm lobular ductal carcinoma

History of coronary artery disease, MI and stent placed six months ago

Do not do lump backed me in sentinel lymph node - because cannot handle the radiation required

Do not give chemo:
Cannot handle the adriamycin that is cardiac toxic
(in general be cautious of getting chemo if greater than 70-75 years old)

**This patient probably's only manage with the aromatase inhibitor**

19

Which chemotherapy agent do you give for tripple negative

"T is for triple"

Taxane

20

When do you get radiation to the axilla

Four or more nodes are positive

N2 or greater (N2 = 4-9 nodes)

21

When you get a radiation after mastectomy

4 or more lymph nodes get axillary radiation

Chest wall involvement

Locally advanced disease - skin involvement

Inflammatory breast disease