• When obtaining a Family History - ask how large the family is (will add more depth to our knowledge of predisposing factors).
  
  

  Posted 11/03/16 08:57:36 AM by Adam Faye

• Supraclavicular Nodes - indicate locally advanced disease.
  Cervical Lymph Nodes - indicates Stage IV disease. 
  
  

  Posted 11/03/16 09:00:13 AM by Adam Faye

• - inflammatory Breast Ca- More aggressive; it is a Clinical Diagnosis (not a pathological one)
  - Staging usually includes bone scan; CT head only performed if focal neuro findings.
  - CA 27.29, 15-3 are used to monitor response/recurrence of disease (Not used for Diagnosis) - debate within the guidelines of whether to use
  
  

  Posted 11/03/16 09:14:11 AM by Adam Faye

• Treatments
  1. Bisphosphonates (Rank-Ligand inhibitors as well) have been shown to decrease prevalence of skeletal-related events/hyperCa in Breast Ca. More recently, may be useful for limiting bone mets.
  2. Anthracyclines are associated with cardiomyopathy (dose dependent) and have increased likelihood of secondary malignancies.
  3. Paclitaxel (microtubule inhibitor) is associated with peripheral neuropathy.
  
  

  Posted 11/03/16 09:27:24 AM by Adam Faye

• Hormone positive metastatic breast cancer:
  • Palbociclib (CDK 4/6 inhibitor) - has shown to prolong progression free survival when combined with fulvestrant (estrogen receptor antagonist)
  • Ribociclib - newer agent (similar to palbociclib in mechanism and toxicity) - looked at patients receiving initial systemic treatment for HR+, HER2 (-) breast cancer. 
  
  

  Posted 11/03/16 09:37:36 AM by Adam Faye

• For further reading...

  Overview of New Therapies/Treatment Options
  
  

  Posted 11/03/16 09:33:03 AM by Adam Faye

Created by Christopher Kelly
The information on the website does not constitute official guidelines except where explicitly stated.
It is not meant to replace the advice of a health professional.