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ON9 Breast Cancer

Deleted user 17 questions Updated 9 Oct 2019

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1Breast Cancer Epidemiology:
- Most common form of cancer in women globally:
Leading cause of cancer [blank_start]death[blank_end] in women worldwide
Survival rates vary worldwide; >80% in North America, <[blank_start]40[blank_end]% in low income countries

- Third most common cancer in New Zealand:
600 deaths every year
[blank_start]3300[blank_end] women diagnosed each year, 25 men
[blank_start]80-92[blank_end]% 10 year survival rate
1. Adeath
2. B40
3. C3300
4. D80-92
2Select all the risk factors for BC.
1. AGene mutation BRCA1/2
2. BFemale
3. CMale
4. DFamily history
5. EAge
6. FEstrogens
7. GAlcohol intake
8. HPost-menopausal obesity
9. IAndrogens
10. JSmoking
3Which of these is NOT a protective factor for BC?
1. AExercise
2. BEarly pregnancy
3. CBreastfeeding
4. DMastectomy
5. EOophorectomy or ovary oblation
6. FSelective estrogen receptor modulators (SERMs)
7. GAromatase inhibitors (AIs)
8. HAppendectomy
4Screening strategies depend on estimated risk of cancer.
Mammogram
[blank_start]Clinical[blank_end] breast exam
Breast [blank_start]self[blank_end]-exam
[blank_start]MRI[blank_end] (high risk)
Biopsy
CT-scan

Follow B.R.A.S: BREAST [blank_start]aware[blank_end], REDUCE [blank_start]risk[blank_end], ACT [blank_start]on changes[blank_end], SCREENING with mammograms [blank_start]over 40[blank_end]
1. AClinical
2. Bself
3. CMRI
4. Daware
5. Erisk
6. Fon changes
7. Gover 40
5Clinical Presentation is variable.
Asymptomatic
Change in [blank_start]general[blank_end] appearance
New/persistent [blank_start]skin[blank_end] changes
New nipple [blank_start]inversion[blank_end]
Nipple [blank_start]discharge[blank_end]
Pain
Variable mass size, [blank_start]texture[blank_end] (nodular, thickened area)
Classically hard, immovable, single lesion irregular borders
1. Ageneral
2. Bskin
3. Cinversion
4. Ddischarge
5. Etexture
6Pathophysiology -
Most common histological types of [blank_start]epithelial[blank_end] breast carcinoma:
Infiltrating [blank_start]ductal[blank_end] carcinoma (70-80%)
Infiltrating [blank_start]lobular[blank_end] carcinoma (~8%)
[blank_start]Mixed[blank_end] ductal/lobular carcinoma (~7%)
1. Aepithelial
2. Bductal
3. Clobular
4. DMixed
7Which of these is NOT a receptor we test for?
1. AHER2
2. BProgesterone (PR)
3. CEstrogen (ER)
4. DBRCA
5. EEGFR
8Choose the incorrect statement.
1. AER and PR are prognostic and predictive factors
2. B25% of all cases are hormone receptor positive and so a candidate for hormone tx
3. CHER2 overexpression present in 15-20% of patients and so it is a candidate for HER2 targeted therapy
9Staging:
Stage 0 – Only in [blank_start]ducts and lobules[blank_end] (no spread)
Stage 1 - Only in [blank_start]breast[blank_end], no nodes
Stage 2 - Early, tumour spread to [blank_start]movable axillary[blank_end] nodes
Stage 3 - Locally advanced disease, spread to chest [blank_start]wall[blank_end], internal [blank_start]mammary[blank_end] lymph nodes
Stage 4 - Advanced or metastatic disease present at [blank_start]distant[blank_end] sites such as bone, liver, lungs, brain
1. Aducts and lobules
2. Bbreast
3. Cmovable axillary
4. Dwall
5. Emammary
6. Fdistant
10Treatment:
1. Surgery - Breast-conserving surgery ([blank_start]lumpectomy[blank_end]) or modified radial [blank_start]mastectomy[blank_end] (removal of entire breast with or without breast reconstruction)

2. Radiation - Mostly used in adjuvant setting, can be targeted or generalized, dose determined by [blank_start]extent[blank_end] of disease, may be used in Stage IV to palliate [blank_start]symptoms[blank_end] for metastases

3. Systemic Therapy - Adjucant: Chemotherapy, endocrine / hormonal therapy, targeted therapy. Reason for [blank_start]mortality[blank_end] reduction in developed countries.
Chemo:
- Chemo regimens [blank_start]similar[blank_end] regardless of hormonal status, but anti-HER2 therapy added on to those HER2 [blank_start]positive[blank_end]
- [blank_start]Anthracycline-based therapy with taxanes[blank_end] (if node positive) appear to have most evidence
Endocrine:
- Used to decrease risk of [blank_start]recurrence[blank_end], initiated [blank_start]after[blank_end] chemotherapy complete
Targeted Anti-HER2 Therapy:
- All are [blank_start]cardiotoxic[blank_end] – need baseline ECHO and follow up
1. Alumpectomy
2. Bmastectomy
3. Cextent
4. Dsymptoms
5. Emortality
6. Fsimilar
7. Gpositive
8. HAnthracycline-based therapy with taxanes
9. Irecurrence
10. Jafter
11. Kcardiotoxic

11Endocrine therapy regimens/options:
1. Pre-menopausal -
High risk? = [blank_start]LHRH agonist + exemestane 25mg[blank_end] PO daily, for 5 years
Low risk? = [blank_start]Tamoxifen 20mg[blank_end] PO daily, for 10 years
Alternative is surgical oophorectomy or medical menopause [blank_start](LHRH agonist) +/- aromatase inhibitor[blank_end]

2. Post-menopausal -
[blank_start]Aromatase Inhibitor[blank_end] (Letrozole, Anastrozole, Exemestane) OR tamoxifen ([blank_start]2nd line[blank_end])
Aromatase Inhibitors drugs of choice in metastatic disease
1. ALHRH agonist + exemestane 25mg
2. BTamoxifen 20mg
3. C(LHRH agonist) +/- aromatase inhibitor
4. DAromatase Inhibitor
5. E2nd line
12Which of the following is most appropriate hormonal therapy for a post-menopausal woman with ER positive breast cancer who has recently finished adjuvant chemotherapy post-total mastectomy?
1. ATamoxifen
2. BLHRH agonist + Aromatase inhibitor
3. CAromatase inhibitor
4. DSurgical removal of ovaries
13Choose the incorrect statement about Trastuzumab.
1. AUsed in metastatic settings
2. BGiven as loading dose and maintenance dose (loading dose infused over 90 min to reduce infusion related reactions)
3. CGiven for 1 year or until disease progression or metastatic
4. DCan be given with chemo / hormonal therapy but give before cycles with anthracycline are complete
14Select ALL correct statements.
1. AChemo and targeted therapies are not used in Stage 0 cancer.
2. BRadiation therapy is only used in Stages 0 and 1.
3. CChemotherapy is used in all stages.
4. DTargeted therapy if patient is HER2+ is used in Stages 1, 2, and 3.
5. EEndocrine therapy is used at all stages if patient is ER-.
15Match the stage to the general Tx:
Stage 0 - [blank_start]Surgery, radiation, +/- endocrine[blank_end]
Early stage - [blank_start]Surgery, radiation, chemo,[blank_end] +/- endocrine +/- targeted
Locally advanced - [blank_start]Surgery, chemo,[blank_end] +/- endocrine +/- targeted
Metastatic - [blank_start]Chemo,[blank_end] +/- endocrine +/- targeted
1. ASurgery, radiation, +/- endocrine
2. BSurgery, radiation, chemo,
3. CSurgery, chemo,
4. DChemo,
16Rachel is a 42 year old pre-menopausal woman attending a breast cancer screening session. Her mother died of breast cancer at age 64. She eats a healthy diet, surfs at least twice weekly, does not smoke, and drinks approximately 3 glasses of wine per week. She works at Dunedin Hospital in the radiotherapy department but adheres to all safety precautions regarding radiation exposure. She has no history of any breast abnormalities.

Identify her risk factors:
- Female, estrogen, [blank_start]age, alcohol intake, family history[blank_end]

Identify two sctreening options for her:
- [blank_start]Mammogram, clinical breast exam[blank_end]
1. Aage, alcohol intake, family history
2. Bexercise, non-smoker
3. CMammogram, clinical breast exam
4. DMRI, breast self-exam
5. EBiopsy, mammogram
17Linda is a 63 year old post-menopausal woman presenting with early stage (stage 2) breast cancer to the left breast. She is ER and HER2 receptor positive. Which of the following is LEAST likely to be recommended for Linda?
1. ASurgery
2. BAdjuvant chemotherapy
3. CRadiation
4. DTargeted therapy

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Description: User has deleted their subject information Quiz on ON9 Breast Cancer, created by Deleted user on 09/10/2019.
Author: Deleted user
Language: English
Views: 107
History: Created on 9 Oct 2019 · updated on 9 Oct 2019
Tags: user has deleted their subject information

ON9 Breast Cancer

Questions in this quiz (17)

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