Module #5: Beyond the Knife

Module #5: Beyond the Knife >> Introduction to Breast Cancer

Balloon brachytherapy

Intraoperative radiation therapy

Canadian hypofractionation

3-D conformal radiation therapy

Tumors > 5 cm

Inflammatory breast cancer

Four or more positive nodes

BRCA+ gene mutation

Prone positioning

CT simulation

Deep inspiration breathhold

All of the above

Hair loss

Fatigue

Pneumonitis

Skin toxicity

A 56 year old who has a total mastectomy with no reconstruction for an inflammatory breast cancer

A 67 year old who has a partial mastectomy for a 1 cm cm triple negative node negative cancer

A 32 year old who has a skin sparing mastectomy with DIEP flap reconstruction for a 3 cm node positive cancer

A 72 year old who has a partial mastectomy for a 0.5 cm ER+ node negative cancer

There is no way to avoid chemotherapy

If she has hormonal therapy, she could avoid chemotherapy

If she maximizes local therapy by having bilateral mastectomies, she could avoid chemotherapy

If she has radiation therapy, she could avoid chemotherapy

Luminal B

Basal

Luminal A

Her2 rich

Trastuzumab

Pertuzumab

Letrozole

Tamoxifen

Peripheral neuropathy

Cardiac toxicity

Bone marrow suppression

Lung toxicity

Better ability to assess response to chemotherapy

All of the above are advantages of neoadjuvant therapy

Ability to shrink large cancers to make breast conserving surgery possible

Improved survival

Module #5: Beyond the Knife >> Introduction to Breast Cancer