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Flashcards in Oncology Deck (57):
1

best initial test breast cancer

biopsy

2

which type of biopsy is the best initial for breast cancer

FNA

3

FN rate of FNA for breast cancer

10%

4

core needle biopsy

LARGER SAMPLE, more deforming, ER/PR/HER2/Neu; possibility that needle will miss the lesion

5

most ACCURATE bx type for breast cancer

open biopsy-- frozen section while in operating room; followed by immediate resection of cancer, followed by sentinel node bx

6

mammography screening-- age start at

50yo

7

NB even if already getting FNA

do MAMMOGRAPHY -- since 5-10% of patients = bilateral

8

MRI use for breast cancer

PRECISE USE NOT clear yet;
young woman with dense breasts

9

US breast cancer

indeterminant mass lessions
cystic vs. solid
if the lesion is PAINFUL
or VARIES in size/pain with MENSES

10

PET scan breast cancer

determine CONTENT of abnormal lymph nodes that are not easily accessible to biopsy

11

BRCA testing

a.w increased risk of breast cancer

12

other cancers a/w BRCA

PANCREATIC and OVARIAN cancer

13

BRCA positive... now what

WILL NOT BE ASKED--since NOT yet shown to add mortality benefit to usual mgmt;
(most go for bilateral mastectomy)

14

sentinel lymph node biopsy

done AT THE TIME of lumpectomy/mastectomy

15

negative sentinel node

ELIMINATES NEED FOR axially lymph node dissection

16

RADIATION for breast cancer

INDISPENSIBLE in preventing cancer RECURRENCES

17

premenopausal option of hormone manipulation breast cancer

tamoxifen

18

postmenopausal option of hormone manipulation breast cancer

aromatase inhibitors

19

letrozole

aromatase inhibitor

20

exemestane

aromatase inhibitor

21

side effect of aromatase inhibitors

OSTEOPOROSIS

22

RADICAL MASTECTOMY

ALWAYS the wrong answer

23

trastuzumab...

DECREASES risk of recurrent disease
INCREASES survival

24

adjuvant chemotherapy for breast cancer

- lesions > 1 cm
- positive axillary nodes are found

25

use tamoxifen when ...

multiple FDR's have breast cancer,
LOWERS RISK of breast cancer

26

lowering mortality

- mammography
- ER/PR testing, then tamoxifen/raloxifene
- aromatase inhibitors
- adjuvant CHEMO
- LUMPECTOMY and RADIATION
- modified radical mastectomy
- TRASTUZUMAB (anti-Her 2/neu)
- prophylaxis with tamoxifen/ raloxifene

27

best initial test for prostate cancer

BIOPSY

28

which is better for survival

prostatectomy MAY SLIGHTLY benefit more than radiation

29

complications of prostatectomy

erectile dysfunction
urinary incontinence

30

erectile dysfunction more likely post-prostatectomy OR radiation

post-prostatectomy

31

side effect of radiation

diarrhea

32

gleason grading

AGGRESSIVENESS or the
MALIGNANT POTENTIAL of prostate cancer

33

high glassine grade

GET IT OUT before it mets

34

helping to control size and progression of mets for prostate cancer

flutamide
GnRH agonists (leuprolide)
ketoconazole
orchiectomy

35

prostate US screening for prostate cancer

NOOOOOOO, always wrong

36

prostate US use...

localize lesions to biopsy if high PSA

37

lumpectomy for prostate cancer

NOOOOOOO, always wrong

38

PSA

NO clear mortality benefit
should NOT be routinely offered to patients
normal PSA doesn't exclude possibility of prostate cancer
above age 75-- DO NOT DO IT-- EVEN IF ASKED

39

PSA and cancer

higher the PSA, GREATER RISK of cancer-- corresponds to volume of cancer

40

patient is requesting a PSA to screen for cancer....

DO THE TEST

41

surgery for lung cancer

SIZE DOES NOT MATTER-- depends on the surrounding lung (ie. BIG lesion with normal surrounding, vs. small lesion with abnormal surrounding)

42

CANNOT DO SX FOR LUNG CANCER

- bilateral disease or lymph nodes positive on opposite side
- malignant pleural effusion
- involvement: heart, carina, aorta, vena cava

43

screening for lung cancer

low dose chest CT:
- 30 pack years
- age 55-80

44

ovarian cancer screening...

NOOOOOO SCREENING

45

ovarian cancer tx

ONLY CANCER-- where removing local metastatic disease will benefit the patient

46

cutting the scrotum for testicular cancer

NOOOOOOOOO DO NOT DO IT

47

needle biopsy of the testicle

NOOOOO WRONG-- since seeding

48

after seminoma orchiectomy, for local disease

radiation

49

after seminoma orchiectomy, for widespread disease

chemo

50

seminomas are sensitive to

CHEMO and RADIATION

51

non-seminomas are sensitive to

CHEMO only

52

does Pap smear lower mortality as much as mammography or colonoscopy

NOOOOO it doesn't

53

HPV vaccines

all women between 11-26yo

54

pap smears

starting at age 21, repeat every 3 years until 65yo

55

of women with fatal cervical cancer-- what % have never had a pap smear

85%

56

ASCUS present

do HPV testing
--> colposcopy

57

ASCUS not associated with hpv

repeat pap smear at 6 months