Breast Oncology

Question 1

What is the difference between NEOadjuvant and adjuvant treatment?

Answer 1

Neoadjuvant treatments are given PRIOR to surgery, and adjuvant treatments are given AFTER surgey

Question 2

How to explain to patients “why we need to give adjuvant treatment” when surgery has already removed most if not all of their tumour/cancer?

Answer 2

• Reduce risk of recurrence to improve/ protect long term survival
• “Mop up any residual cancer tissue in the body”
• “Preventative measures”
• “Treating risk, not cancer”
• “Treating the population, not individual” (not every individual would benefit from the adjuvant available, but at the current stage we cannot predict accurately, only time can tell)

Question 3

Does giving chemotherapy as either neoadjuvant or adjuvant therapy change the long-term control measures?

Answer 3

NO

Question 4

When do we give NEOadjuvant chemotherapy?

Answer 4

For the poorer prognosis/more aggressive types of breast cancer to 1)try and shrink tumour 2)test biology of cancer to see if the chemo would actually cause beneficial effect:
- Triple negative
- HER-2 positive
- Inflammatory

Question 5

Also include rationale

Answer 5

Answer is D - we treat male and female breast cancer patients similarly

Why not:
B - for metastatic disease we would not perform surgery
C - patients who are ER + HER - would not be given neoadjuvant chemo
E - the NACT, and actually many SACT, carry cardio and renal toxicity, which is not compatible with the patient given her PMH

Question 6

What is the difference between the oncologists’ palliative treatment and palliative care?

Answer 6

Palliative treatment: to treat and control cancer, improve symptoms & prolong life

Palliative care: to relieve pain, improve symptoms & stress caused by serious illness

Question 7

What does EC stand for?

Answer 7

A combination chemotherapy of the anthracycline epirubicin and cyclophosphamide