cancer test 2 breast cancer

Question 1

risk factors for breast cancer

Answer 1

female
increased age
alcohol
personal history of breast cancer
hormonal factors
nulliparity or late age of 1st pregnancy
not breastfeeding for up to a year
hormonal replacement therapy
dense breast tissue
late menopause
family history of breast cancer
BRCA 1 and BRCA 2 mutations

Question 2

modifiable risk factors for breast cancer

Answer 2

-obesity and weight gain after menopause
-high-fat diet
-sedentary lifestyle
-alcohol
-smoking
-night shift

Question 3

malignant signs for breast cancer

Answer 3

nontender, poorly defined hard lesions

Question 4

advanced signs of malignant breast cancer

Answer 4

skin dimpling, nipple retraction, skin ulceration

Question 5

to detect any malignancies that r in the ducts if they have abnormal discharge from the nipple

Answer 5

galactography

Question 6

gold standard for women with average risk of breast cancer. usually done every year

Answer 6

mammography

Question 7

gold standard surgical biopsy for palpable breast tumors. aka lumpectomy

Answer 7

excisional biopsy

Question 8

what agents should be discontinued for someone getting a surgical biopsy

Answer 8

anything that can increase risk of bleeding like ASA, NSAIDS, vitamin E, ginkgo, garlic, coumadin

Question 9

some benign conditions of the breast

Answer 9

mastalgia
cysts (fibrocystic breast disease)
fibroadenomas
atypical hyperplasia
lobular carcinoma in situ

Question 10

two non cancerous breast diseases that can increase risk for cancer

Answer 10

-atypical hyperplasia
-lobular carcinoma in situ (LCIS)

Question 11

proliferation of malignant cells inside milk ducts without invasion

Answer 11

ducati carcinoma in situ (DCIS)

Question 12

DCIS

Answer 12

-will turn invasive if not treated
-mammogram to show calcifications
-considered stage 0 breast cancer
-diagnosed with biopsy
- estrogen most common reason for this type of cancer
- breast conservation treatment (lumpectomy, wide excision, segmental mastectomy)

Question 13

-caused by malignant cells that r blocking the lymph channels in the skin. sometimes mistaken as infection
-orange
-chemo, radiation, then surgery

Answer 13

peau d’orange (inflammatory)

Question 14

malignancy of mammary ducts

Answer 14

paget’s disease

Question 15

early sign of pagets

Answer 15

nipple and areola may have redness

Question 16

late sign of pagets

Answer 16

scaling and thick, looks eroded

Question 17

stage 0 breast cancer characterization

Answer 17

in situ, early type of breast cancer

Question 18

stage 1 breast cancer characterized

Answer 18

localized tumor <1 inch in diameter

Question 19

stage 2 breast cancer characterized

Answer 19

tumor 1-2 inches in diameter, spread to axillary lymph nodes

Question 20

stage 3 breast cancer characterized

Answer 20

tumor 2 inches or larger, spread to other lymph nodes and tissues

Question 21

stage 4 breast cancer characterized

Answer 21

cancer has metastasized to other body organs

Question 22

prevention strategies in high risk patient for breast cancer

Answer 22

-combo of genetic, hormonal, environmental
-long term surveillance
-chemo prevention (tamoxifen and raloxifene)
-prophylactic mastectomy

Question 23

clinical manifestations of breast cancer

Answer 23

-upper outer quadrant
-nontender, fixed and hard with irregular borders
-no s and s other than a mammographic abnormality

Question 24

determines staging and prognosis for breast cancer

Answer 24

biopsy

Question 25

goal of surgery for breast cancer

Answer 25

to regain control of the disease

Question 26

lumpectomy, wide excision, partial or segmental mastectomy

Answer 26

breast conservation treatment

Question 27

indications for mastectomy

Answer 27

-history of radiation to breast or chest wall -inflammatory breast cancer -diffuses suspicious or malignant appearing calcifications -widespread disease -positive margins after repeat re-excision -tumors greater than 5cm in diameter -focally positive margins -<35 yr olds, BRCA1 or 2 mutations

Question 28

treats invasive breast cancer -removal of breast, nipple, areola, and a portion of axillary lymph node

Answer 28

modified radical mastectomy

Question 29

removes breast, nipple, and areola but not the axillary lymph nodes -usually for non invasive breast cancers like DCIS

Answer 29

total/ simple mastectomy

Question 30

most important prognostic factor in breast cancer

Answer 30

status of lymph nodes

Question 31

shorter operating room time

Answer 31

SLNB

Question 32

longer operating room time

Answer 32

ALND

Question 33

no surgical drain

Answer 33

SLNB

Question 34

has surgical drain

Answer 34

ALND

Question 35

lymphedema risk minimal

Answer 35

SLNB

Question 36

lymphedema risk higher

Answer 36

ALND

Question 37

presence of neuropathic sensations postoperatively

Answer 37

ALND

Question 38

decreased rom post op

Answer 38

ALND

Question 39

seroma may occur post op

Answer 39

ALND

Question 40

who’s not a good candidate for tissue expander

Answer 40

woman who’s had radiation or connective tissue disease

Question 41

what can’t someone get done with a tissue expander in

Answer 41

MRI

Question 42

who’s not a good candidate for TRAM flap

Answer 42

diabetes or other comorbidities

Question 43

complications of TRAM flap

Answer 43

-breathing because they don’t take deep breaths due to abdomen surgery at risk for DVTs and atelectasis

Question 44

post op education for breast surgery

Answer 44

-tenderness, soreness, tingling will go away -can have neuropathic pain after chronically

Question 45

doxorubicin, cyclophosphamide, paclitaxel (chemo) can cause what SE

Answer 45

cardiac toxicity and bone marrow suppression, n/v, alopecia, mucositis, anaphylactic, weight gain, taste changes, skin changes, fatigue, neuropathy, amenorrhea

Question 46

management of bone marrow suppression

Answer 46

neupogen, neulasta erythropoietin

Question 47

premenopausal tend to be

Answer 47

estrogen receptors negative

Question 48

post menopausal women tend to be

Answer 48

estrogen receptors positive

Question 49

treats hormone receptor plus breast cancer

Answer 49

tamoxifen

Question 50

treats osteoporosis in post menopausal women

Answer 50

raloxifene

Question 51

anastrozole exemestane

Answer 51

aromatose inhibitors (lower estrogen levels)

Question 52

SE of hormonal therapy for breast cancer

Answer 52

hot flashes, night sweats, vaginal dryness, discharge, bleeding, mood disturbances, DVTs or PEs, bone thinning, osteoporosis