Oncology Flashcards
What is a classic risk of tamoxifen
It acts like estrogen and increases risk of endometrial CA. It also reduces bone fx, increases VTE, increases leg cramps
Who should start tamoxifen preventatively
The U.S. Preventive Services Task Force recommends that the selective estrogen receptor modulators tamoxifen and raloxifene be offered to women at high risk for breast cancer and low risk for adverse medication effects
recommended colorectaal cancer follow-up after treatment
The National Comprehensive Cancer Network, for example, recommends that people who are treated for stage II or III colon or rectal cancer have CEA testing every 3 to 6 months for 2 years and then every 6 months for 3 additional years, plus CT scans every 6 to 12 months for 5 years.
Recommendations for routine Breast CA screening
50-74 yrs old every 2 years. Continue after 75 if life expectancy > 10yrs
Who should have an annual breast MRI and annual mammography?
The American Cancer Society (ACS) recommends that all high-risk women — those with a greater than 20% lifetime risk of breast cancer (e.g. BRCA+) — have a breast MRI and a mammogram every year. For most women, these combined screenings should start at age 30 and continue as long as the woman is in good health.
If can’t get the recommended annual MRI, substitute with…
US
Most common type of Breast CA
Ductal Carcinoma (starts as epithelial cell Ductal Carcinoma in-situ or DCIS) Has tendency to cross basement membrane to become invasive. Second is Lobular Carcinoma- Starts as carcinoma in-situ of lobule and usually stays localized. No calcification so not easily seen with mammography
If palpable breast lump in patient 30yr or older what is the work-up algorithm
If normal breast consistency, Mammogram followed by cytology (FNA) and histology (Core biopsy)
If palpable breast mass in patient under 30yrs old
go to Ultrasound then Cytology (FNA) and Histology (CNB)
What is the TNM system of Breast CA staging
T- describes size of tumor and local extension
N- Lymph node spread
M- Metastases
Each is ranked 0-IV and the Breast Cancer then staged 0-4
0- no spread
1,2,3 non metastatic
4 - metastatic
cervical cancer screening guidelines
<21 yrs no screening
21-29 yrs cytology alone every 3yrs
20-65– could continue do cytology every 3 yrs OR HPV test every 5 yrs OR both
Who get the 3 dose HPV vaccine?
Teens and young adults who start the series at ages 15 through 26 years need three doses of HPV vaccine to protect against cancer-causing HPV infection
