Breast Cancer- Oncology Treatment Flashcards Preview

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Flashcards in Breast Cancer- Oncology Treatment Deck (13):
1

How is DCIS managed?

Surgery (Breast conservation surgery or mastectomy) followed by Radiotherapy to the whole breast, 40Gy in 15# over 3 weeks, using 2 tangential fields

2

What % of breast lumps are operable?

84%
8% distant mets
8% locally advanced/inoperable

3

When does radiotherapy following BCS involve irradiation of breast alone?

Negative sentinel node biopsy (SNB)
Nodes containing micrometastases only (>0.2mm but <2mm) in SNB
< 4 nodes involved in an adequate axillary node clearance

4

When does radiotherapy following BCS involve a boost to the tumour bed?

Women under the age of 54 on the day of surgery
Posterior margin <1mm for invasive disease after full thickness excision

5

When is chest wall radiotherapy given following mastectomy?

Tumour size > 5 cm
4 or more involved nodes
Involved resection margins
T4 disease

6

When is radiotherapy to the ipsilateral axilla given?

>1 positive macrometastases sentinel node
Extensive ECS post axillary clearance

7

When is radiotherapy to the supraclavicular fossa given?

>=4 nodes involved

8

Who should be considered as having involved nodes?

Patients with histologically proven lymph node involvement in whom there is a complete pathological response (scarring in node) within the nodes following neo-adjuvant systemic treatment

9

What nodes should not be considered involved?

Nodes containing isolated tumour cells (<0.2mm of disease)

10

How long are tamoxifen and letrozole given in adjuvant treatment?

10y and 5y respectively

11

When is trastuzumab given?

To patients whose cancer cells overexpress HER-2-neu as measured by IHC or FISH (25-30% of pts)

12

In locally advanced cancer when should radiotherapy be considered?

As initial therapy for a primary tumour that is considered inoperable
Also consider for patients still inoperable following primary systemic therapy
Consider post surgery for all patients
Patients with T>4b tumours at outset should be treated with 0.5cm bolus following mastectomy to increase the skin dose

13

Where does breast cancer commonly metastasise too?

Lung
Liver
Bone
Brain
Skin