PPEN
T or F - 5 year survival rate is 73%.
What is false? 5 year survival rate = 87%
T or F - Typical BRCA genes produce proteins that suppress tumor growth.
What is true?
T or F - First 4 cycles of AC-T are of adriamycin and cyclophosphamide and the last cycle is taxol.
What is true?
A - damages DNA of cancer cells and prevents their growth
C - stops certain protein synthesis in cancer cells and prevents their reproduction
T - damages the structure or "skeleton" that supports cancer cells and prevents division and growth
T or F - a high score on the Edmonton Symptom Assessment System means less symptoms.
What is false? 0 = no symptom, 10 = worst possible symptom
T or F - Cannabis is contraindicated in patients with cancer.
What is false? Examples of use include pain, nausea, and vomiting.
The fraction of Canadian women that will develop it over their lifetime.
What is 1/8? 12000 in ON in 2020, 2000 in ON will dies of BC in 2020, BC accounts for 25% of all female cancers
T or F - Grade 2 includes is well differentiated (anaplasia) tissue cells.
What is false?
Grade 1: well differentiate (anaplasia) tissue cells, cells generally appear normal and are NOT growing rapidly.
Grade 2: moderately differentiated tissue cells
Grade 3: poorly differentiated tissue cells, cells do not appear normal and tend to grow and spread aggressively
T or F - Axillary dissection has more favorable prognosis than sentinel dissection.
What is false? Sentinel node has more favorable prognosis.
T or F - A score of 13.5 on the TUG predicts falling in community-dwelling frail elders.
What is true?
Identify one community-based program that provides exercise for women with breast cancer.
What are CanWell Program, YWCAencore, McMaster Physical Activity Centre of Excellence (PACE), Mac Warriors, CanSoar, Wellwood, Wellspring Niagara?
Three components of triple negative.
What are no estrogen, no progesterone, and normal Her2 protein status?
FYI 10-15% of BCs are triple negative
Describe stage 2.
Stage 1: T <2cm, N none, M none
Stage 3: T >5cm, N yes ipsilateral, M none
Stage 4: T doesn't matter, N doesn't matter, M yes
Type of mastectomy that removes all breast, chest muscles, and all lymph nodes under arm.
What is radical mastectomy?
Total = removes all of breast, but not nearby lymph nodes
Modified radical = removes all breast, most/all lymph nodes, and the lining over the chest muscle. The chest muscle is usually left intact.
A score of 22 on the Godin Leisure Time Exercise Questionnaire is interpreted as this category.
What is moderately active?
24 units or more = active
14-23 = moderately active
less than 14 = insufficiently active/sedentary
FYI: total leisure activity score = (9*strenuous) + (5*mod) + (3*light)
List three psychosocial issues of breast cancer diagnosis.
What are PTSD, anxiety, depression, adjustment disorders, financial stress, impairment, etc.?
Three types of breast cancer.
What are ductal carcinoma, lobular carcinoma, and inflammatory?
List 3 signs and symptoms as the tumor grows.
What are palpable lump (ductal carcinoma), thickening/hardening of breast tissue (lobular carcinoma), lump in axilla, changes in shape/size of breast, nipple changes, and discharge.
FYI: There are no signs and symptoms in the early stages.
Difference between adjuvant and neo-adjuvant chemotherapy.
What is:
Adjuvant: performed after surgery to target any remaining cancer cells/prevent recurrence (typically stage 1 and 2)
Neo-adjuvant: done before surgery to shrink tumor, (typically stage 3 and 4)
5 domains of the FACT-B
What are physical, social, emotional, functional wellbeing, and breast cancer?
FYI: 50% of items need to be filled out for it to count, responses apply within last 7 days. High score = better quality of life
List four barriers to exercise participation.
Institutional barriers: time w/ each pt, so many issues to discuss, lack of identification in institution who should be discussing exercise, lack of funding for exercise interventions
HCP barriers: lack of specific knowledge about exercise, discussion of exercise is low priority
Perceived pt barriers: negative attitude toward exercise, lack of accessibility, cost, transportation, weather constraints, pt side effects and symptoms, pt time, pre-cancer fitness levels, treatments received, comorbidities
Describe the natural history.
What is pre-cancer -> cancer in situ -> invasion of normal breast -> spread to regional lymph nodes -> spread to distant organs?
List 5 risk factors.
What are genetic mutations, hx of BRCA, reproductive hx (early pregnancies reduce risk), breast density, oral contraceptives, alcohol, obesity, physical inactivity, exposure to radiation, hormone replacement therapy?
Purpose of neupogen.
FYI: Side effects include mild to moderate bone pain, fever, diarrhea, skin rash, weakness, enlargement and rupture of spleen
List the ESAS scoring interpretation and MCID for single scores.
What is MCID = 1?
0 = none
1-3 = mild
4-6 = moderate
7-10 = severe
List exercise guidelines for patients with cancer.
What are:
Aerobic: 90-150 min/week, break into small ~30 min bouts at least 3 times per week, moderate intensity
Strength: 2+ days/week; 2 sets of 8-15 reps, all major muscle groups, at least 60% of 1RM
Flexibility: 4+ days/week, all major muscle groups