neoplasia 3 Flashcards
(24 cards)
screening
ex:
whats taken into account?
asymptomatic patients - healthy, preventative measure. screen for pre-malignant process.
ex: pap smears, breast, colon (FIT testing, colonoscopy), testicle, prostate.
take into account family history of genetic disease (HNPCC & BRCA)
HNPCC
hereditary nonpolyposis colorectal cancer
- DNA repair hindered. screen annually/bi-annually.
BRCA
breast cancer susceptibility gene
high risk for breast and ovarian cancer. screening , after child bearing years, prophylactic removal.
papanicoloau test
swab outside lining of cervis. superficial epithelial to test for infected cells.
in lab, stained. if dark blue positive for HPV.
mammography
parallel plates compress breast tissue.
lmages show breast tissue
colon screening
FIT - fecal immunochemical test - detect blood in stool.
warning signs
change in bowel, bladder habits, sore doesnt heal unusual bleeding/discharge lump in breast indigestion or difficult swallowing change in wart or mole
serious signs
– usually waited too long
weight loss
night sweats
enlarged lymph nodes
clinician - tests they ask for
imaging - (family doc, specialist) -US, x-ray, CT
blood test (fam doc, surgeon) - prostate specific antigen, hCG, CA-125
cytopathology (radiologist, specialist) - FineNeedleAspirate, cavity taps (suck out cells)
biopsy (fam doc, specialist, surgeon) - skin, GI, endobronchial biopsies.
resection - surgeon
cytopathology
diagnosis of disease at cytological level.
assess nuclei
assess cellularity and basic architecture.
screening - pap smear
diagnosis - fine needle aspiration. fluids
tissue diagnosis
biopsies – resection specimen observation, treatment
biopsies - purpose
making diagnosis, guiding next step.
purpose resection specimens
staging tumor, grading tumor, guiding further therapy, prognostic info
treatment types
surgery radiation therapy chemo immune therapy tumor specific therapy additional investigations. - molecular studies
screening for tumor associated antigens.
there are sometimes false negatives, false positives.
ex: PSA for prostate is garbage. only do if in family history
diagnosis for tumor associated antigens.
testicular cancer: hCG, LG, AFP –> no biopsy, just remove whole testicle.
ovarian mass: CA-125 - secreted by neoplasms and non-malignant conditions
follow up for tumor associated antigens
treatment for effectiveness and recurrnece.
CEA for colon cancer. if tumor is secreting something treatment should reduce
invasiveness - key
key to malignancy.
colonic adenoma vs adenocarcinoma = same genetic mutation, when confined to surface = not malignant.
melanoma-in-situ vs melanoma = mole changes colour
high grade vs invasive.
ductal carcinoma in-situ vs invasive.
- risk of metastasis once tumor invades beyond basement membrane
tumor staging.
breast
prostate
colon
breast = nottingham score prostate = gleason score colon = based on architecture
staging is both subjective and objective
nuclear atypia = subjective - how abnormal is nucleus
architecutre abnormalities - subjective - how abnormal is gland/organ
mitotic counts: counting mitosis - objective
breast cancer grading
nottingham grade
- tubule formation
nuclear pleomorphism
mitotic counts.
tumor stage - assesses?
assesses extent of spread.
info about risk of metastasis.
info about prognosis.
pathological staging -TNM
T = tumour (size,depth, invasion) N= nodes( number, size of deposit, matting) M = metastasis (distance varies between organ)
clinical stage groupings
combo of pathological stage.
guides treatment decisions
