CBCN flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- BRCA1 lifetime breast cancer risk
- Pathogenic BRCA1 variants carry a lifetime breast cancer risk of about 55-72% plus elevated ovarian cancer risk; BRCA2 carriers have a lifetime breast cancer risk of roughly 45-69%.
- Gail model chemoprevention threshold
- A 5-year Gail (BCRAT) risk of 1.67% or higher is the usual threshold for discussing breast cancer chemoprevention with tamoxifen, raloxifene, or an aromatase inhibitor.
- LCIS significance
- Lobular carcinoma in situ is a marker of increased bilateral breast cancer risk of about 1% per year, not a direct precursor; management is surveillance with or without chemoprevention.
- Atypical hyperplasia risk
- Atypical ductal or lobular hyperplasia raises breast cancer risk about fourfold; it is included in the Gail model and supports discussion of chemoprevention.
- MRI screening risk threshold
- Women with a lifetime breast cancer risk of 20-25% or more, such as BRCA carriers, should have annual breast MRI in addition to mammography.
- Tail of Spence
- The Tail of Spence is the upper-outer extension of breast tissue into the axilla; it is a site where breast tissue can be missed on examination or imaging.
- Prolactin and nipple discharge
- Bilateral milky nipple discharge suggests hyperprolactinemia, so a serum prolactin level is the appropriate first test, whereas bloody unilateral discharge needs duct imaging.
- BI-RADS 3
- BI-RADS 3 means probably benign, with a malignancy risk under 2%; management is short-interval follow-up imaging rather than immediate biopsy.
- BI-RADS 5
- BI-RADS 5 is highly suggestive of malignancy, with a risk of 95% or greater; biopsy is required and malignant pathology is expected.
- T2 breast tumor
- In AJCC staging, a T2 breast tumor is greater than 2 cm but not more than 5 cm in greatest dimension; T1 tumors are 2 cm or less.
- Stage IV breast cancer
- Any M1 disease is stage IV breast cancer regardless of tumor or node category; common distant sites include bone, liver, lung, and brain.
- Sentinel lymph node biopsy indication
- Sentinel lymph node biopsy is the standard axillary staging method for clinically node-negative breast cancer and carries a lower lymphedema risk than axillary dissection.
- Triple assessment
- Diagnosis of a breast mass uses triple assessment: clinical examination, imaging, and tissue sampling; core needle biopsy is preferred over fine-needle aspiration.
- HER2-positive definition
- HER2-positive breast cancer is defined by IHC 3+ staining or by in situ hybridization showing gene amplification; these tumors benefit from trastuzumab-based therapy.
- Tamoxifen duration and risks
- For premenopausal women with ER-positive breast cancer, tamoxifen is given for 5 to 10 years and carries risks of venous thromboembolism and endometrial cancer.
- Aromatase inhibitor use
- Aromatase inhibitors are effective only in postmenopausal women with ER-positive disease; they cause bone loss and arthralgia, so bone density should be monitored.
- Trastuzumab LVEF monitoring
- Trastuzumab can reduce left ventricular ejection fraction; LVEF is checked at baseline and every 3 months during therapy, and the drug is held for significant decline.
- Neutrophil nadir timing
- The absolute neutrophil count typically reaches its nadir about 7 to 14 days after chemotherapy administration, so febrile neutropenia risk peaks in that window.
- Anthracycline cardiotoxicity
- Doxorubicin causes cumulative, dose-dependent cardiomyopathy; baseline and serial LVEF monitoring is required, and dexrazoxane may be used as a cardioprotectant.
- CDK4/6 inhibitor toxicities
- Palbociclib, ribociclib, and abemaciclib commonly cause neutropenia; ribociclib also prolongs QTc and abemaciclib causes diarrhea, so CBC and ECG monitoring are needed.
- Ovarian suppression plus endocrine therapy
- High-risk premenopausal women with ER-positive disease may receive ovarian suppression with a GnRH agonist plus an aromatase inhibitor or tamoxifen.
- Febrile neutropenia definition
- Fever is a single temperature of 38.3 °C or higher, or 38.0 °C sustained for an hour, with an ANC below 500/µL; antibiotics start within 60 minutes.
- Antiemetic triple combination
- Highly emetogenic chemotherapy requires a 5-HT3 antagonist, dexamethasone, and an NK-1 receptor antagonist, often with olanzapine added to prevent breakthrough nausea.
- Distress thermometer cutoff
- A distress thermometer score of 4 or greater on the 0-10 scale warrants referral to psychosocial or supportive care services for further evaluation.
- Dexrazoxane for extravasation
- Dexrazoxane is the antidote for anthracycline extravasation and also a cardioprotectant; stop the infusion, aspirate residual drug, then give dexrazoxane promptly per protocol.
- Paroxetine and tamoxifen interaction
- Paroxetine and fluoxetine strongly inhibit CYP2D6 and reduce conversion of tamoxifen to endoxifen, so venlafaxine is preferred for treating hot flashes.
- Malignant hypercalcemia treatment
- Symptomatic malignant hypercalcemia is treated with intravenous isotonic saline plus an IV bisphosphonate such as zoledronic acid, with monitoring of calcium and renal function.
- Survivorship care plan
- A survivorship care plan summarizes treatments received, the surveillance schedule, potential late effects, and health promotion recommendations, and is given at the end of active treatment.
- Post-treatment surveillance schedule
- After curative treatment, history and physical occur every 3-6 months for 3 years, then every 6-12 months to year 5, with annual mammography.
- Fertility preservation timing
- Fertility preservation counseling and referral should happen before gonadotoxic chemotherapy begins; options include oocyte or embryo cryopreservation and GnRH agonist ovarian suppression.
- Hospice prognosis criterion
- Hospice eligibility generally requires a prognosis of 6 months or less if the disease follows its natural course, with care focused on comfort and quality of life.
- Fear of recurrence
- Fear of recurrence is one of the most common psychosocial concerns among breast cancer survivors and should be screened and addressed at follow-up visits.