Pearls from Dr. Kevin Kalinsky

63 yo woman with new presentation of metastatic bony lesions found to have breast cancer


  • Cancers that metastasize to bone:

    Posted 08/23/16 10:03:48 AM by Anna Krigel

  • Urine dipstick for urinalysis detects only albumin and not immunoglobulins, thus not picked up in multiple myeloma

    Posted 08/23/16 10:05:05 AM by Anna Krigel

  • Clinical evaluation of palpable breast masses

    Posted 08/23/16 10:23:50 AM by Anna Krigel

  • Breast biopsy

    Posted 08/23/16 10:26:16 AM by Anna Krigel

  • Hormonal treatment
    HER2 positive treatment

    Posted 08/23/16 10:38:32 AM by Anna Krigel

  • 54 y/o woman presenting with breast firmness and ulcerations- found to have metastatic Breast Ca


  • 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:

    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

  • 62yo F with new breast mass, found to have ER+/PR+ Her2neg breast Ca


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