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PA40157 Cancer > Breast Cancer > Flashcards

Breast Cancer Flashcards

(55 cards)

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1
Q

What cancer is the most common in UK women?

A

Breast cancer

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2
Q

How much does the incidence of breast cancer increase every 10 years?

A

doubles every 10 years until menopause when the rate of increase slows

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3
Q

What are the risk factors for developing breast cancer?

A 
Age
Geographical Location
Age of menarche and menopause
Age at first full term pregnancy
Lactation
Weight
Diet
Alcohol
Radiation
Oral contraceptives
HRT
Previous benign breast disease
Family history: BRCA1 & BRCA2
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4
Q

What does FNA stand for and what is it ?

A

Fine Needle Apsarate

Biopsy of mass

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5
Q

What examinations do people with suspected breast cancer have?

A 
Mammogram
FNA
Physical examination of lymph nodes
Chest x ray
CT scan
Breast ultrasound
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6
Q

Where can breast cancer commonly metastasise to?

A

Chest
Abdomen
Pelvis

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7
Q

Mammogram screening should occur how often?

A

every 3 years

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8
Q

What are the size of tumours in early breast cancer?

A

<2cm

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9
Q

What are the size of tumours in locally advanced breast cancer?

A

> 5cm

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10
Q

What is the survival like for early breast cancer?

A

85% 15 year survival

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11
Q

What is the survival like for metastatic breast cancer?

A

<5% 15 year survival

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12
Q

What are the adverse prognostic factors for breast cancer?

A 
High TNM stage
Poorly differentiated tumours
Lymph or vascular invasion
ER or PR -ve
HER2 +ve
Young age at diagnosis
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13
Q

What is checked for each cancer?

A

ER +ve

PR+ve

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14
Q

What are the treatment options for breast cancer?

A 
Surgery
Radiotherapy
Chemotherapy
Hormonal therapies
Monoclonal antibodies
New agents e.g.palbociclib
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15
Q

What are the two types of breast cancer surgery?

A

Mastectomy

Wide local excision

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16
Q

What patients get radiotherapy?

A

All patients who have had wide local excision and patients who have had mastectomy and are at high risk of recurrence

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17
Q

Why is radiotherapy good?

A

It reduces the risk of relapse and improves overall survival as eradicates micro deposits of cancer cells

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18
Q

How often is radiotherapy given?

A

Given for 5 days a week for 3-5 weeks

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19
Q

What are the four hormonal medicines used for breast cancer?

A

Tamoxifen, Anastrozole, Letrozole, Exemestane

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20
Q

What women are given hormonal therapy treatment?

A

All women with ER/PR +VE tumours

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21
Q

How long are hormonal therapies given for after surgery?

A

5-10 years

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22
Q

What is the theory for using hormonal therapies for breast cancer?

A

Sensitive cancer cells need oestrogen to stay alive and therefore removal of oestrogen is very effective at controlling or killing hormone-sensitive cancer cells

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23
Q

What are hormonal therapies also used for in breast cancer?

Study These Flashcards
A

As a neo-adjuvant therapy (before surgery) to shrink large tumours and facilitate breast conserving surgery

24
Q

What is tamoxifen?

Study These Flashcards
A

Oestrogen antagonist which acts at oestrogen receptors on cells

25
Tamoxifen reduces the risk of reoccurence of breast cancer by how much?
50%
26
What are the side effects of Tamoxifen?
Hot flushes Weight gain Sweats Increased risk of developing endometrial cancer
27
What are the three aromatase inhibitors?
Anastrozole Letrozole Exemestane
28
what do the aromatase inhibitors do?
Block conversion of androgens from adrenal cortex--> oestrogens in peripheral tissue
29
Who are aromatase inhibitors only effective in?
Postmenopausal women
30
Which aromatase inhibitor is the agent of type in postmenopausal women?
Anastrozole
31
What are the side effects of anastrozole inhibitors?
Decreased bone density
32
What is chemotherapy used for in breast cancer?
As an adjuvant treatment for patients at intermediate or high risk of recurrence
33
What type of regimens are most effective (chemo) in breast cancer?
Anthracycline based
34
Who is chemo most effective in?
Pre-menopausal women, node+ve patients
35
What are the main side effects of FEC-T chemotherapy?
``` Nausea &vomiting Alopecia Bone marrow suppression Mucositis Red urine for 24 hours post epirubicin Diarrhoea/constipation Lethargy Cardiotoxicity Docetaxel-nail changes, arthralgia/myalgia ```
36
Describe the sequence of FEC-T regimen?
Cycles 1-3: fluorouracil IV bolus, epirubicin IV bolus, cyclophosphamide IV short infusion Cycles 4-6: Docetaxel IV infusion over 1 hour
37
What should happen if a patient's neutrophils are too low when a person is due their next cycle?
Delay cycle for 1 week
38
What side effect can Ondansetron cause?
Headaches
39
Which has less incidence of headaches, ondansetron or granisetron?
Granisetron
40
What would be the symptoms if Hb dropped to 8,5?
Lethargy SoB Dizziness Palpitations/angina
41
What would be the symptoms if platelet count dropped to 68?
Bleeding-prolonged from cuts, gums Easy bruising Petechiae
42
when should antiemetics be started when having chemo?
Day before chemo
43
What is Herceptin/Trastuzumab?
Recombinant humanised monoclonal antibody which targets HER2 protein
44
What is herceptin approved for?
Metastatic breast cancer | Early breast cancer
45
How often is Herceptin given for early breast cancer?
Every 3 weeks for 1 year
46
What are the side effects of Herceptin?
``` Cardiotoxicity Nausea & Vomiting Diarrhoea Myalgia/arthralgia Rash ```
47
``` How long do the following last: Chemo Radio Trastuzumab Hormonal therapy ? ```
Chemo: 5 months Radio: 4 weeks Trastuzumab: 1 year Hormonal: 5-10 years
48
What does palbociclib do?
Inhibitor of cyclin dependent kinases (CDK) 4 and 6. | Blocks progression of the cell from G1 into S phase
49
What is palbociclib approved for?
Untreated metastatic breast cancer (ER+ve, HER-ve) in combination with an aromatase inhibitor
50
Is palbociclib given IV or PO?
PO
51
How often is Palbociclib given?
Daily for 21 days out of 28 day cycle
52
How long is palbociclib taken for?
Until disease progressopn/intolerable side effects
53
What are the side effects of palbociclib?
Neutropenia and infections Fatigue Nausea Stomatitis
54
What is Pertuzumab?
A monoclonal antibody which targets a specific domain of the HER2 protein
55
What is Pertuzumab licensed for?
Neoadjuvant treatment of early breast cancer and in metastatic disease

PA40157 Cancer (10 decks)

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