Kaplan High Yield Oncology 1. Breast Cancer a. Presentation: i. Palpation of a mass —Hard, immobile, fixed to chest wall . ii. Painless lump, skin changes, nipple retraction, nipple discharge b. Types: i. Ductal-80%, Lobular-20% c. Diagnosis i. Biopsy is the best initial test ii. Other methods: 1. FNA (best initial biopsy) a. High false negative rate – 10% 2. Core needle biopsy a. Able to tell receptor status (Estrogen/prog) 3. Open surgical biopsy a. Most accurate test d. Mammography i. Screen general population starting at age 50 e. Ultrasound i. Used for indeterminate lesions. ii. Cyst vs. solid iii. PAINFUL & variable w/ menstruation f. Surgery options i. Lumpectomy ii. Modified radical mastectomy iii. Radical mastectomy 1. Not proven to be more beneficial. g. Systemic therapy i. Trastuzumab (anti-HER-2/neu receptor antibody) h. ER + , PR + i. Tamoxifen, Raloxifene 1. SE endometrial cancer & clots ii. Aromatase inhibitors: anastrozole, letrozole, exemestane 1. BETTER CHOICE 2. SE: osteoporosis
