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breast cancer T3 N2 M0
It refers to a large tumor that has spread
outside the breast to nearby lymph nodes,
but not to other parts of the body.
Prostate cancer T2 N0 M0
It means that the tumor is located only in the
prostate and has not spread to the lymph
nodes or any other part of the body.
Stage I ( T1, N0, MO)- Early Stage
Stage II (T2, N1, M0) – local Spread
Stage III ( T3, N2, M0)- extensive
spread but no metastasis.
Stage IV (T4, N3, M+) Advanced
stage, with distant metastasis
5 Main Categories of
Cancer
– In situ is early cancer that is present
only in the layer of cells in which it
began.
– Localized is cancer that is limited to the
organ in which it began, without
evidence of spread.
– Regional is cancer that has spread
beyond the original (primary) site to
nearby lymph nodes or organs and
tissues.
Diagnostic Abilities Limited ability to specifically diagnose benign Strong ability to specifically
lesions diagnose benign lesions.
No ability to differentiate between in situ and Some ability to differentiate
invasive breast cancer between in situ and invasive breast
cancer.
Disadvantages Cannot be used for additional study More invasive, time consuming,
expensive
Advantages Inexpensive, quick, readily available, and very Can be used for additional study
safe and has more specific diagnostic
abilities than FNA
Effectiveness Sensitivity: 75.8-98.7% Sensitivity: 91-99.6%%
Specificity: 60-100% Specificity: 98-100%
Positive Predictive Value: 93.5-100% Positive Predictive Value: 10
Analysis of FNA
Benign - the mass is not of much concern and will
not cause any significant problems as long as it
remains unchanged.
Atypically indeterminate - a diagnosis cannot be
obtained from the sample. Other tests are needed
to determine the nature of the lesion.
Suspicious/probably malignant - not a diagnosis of
cancer. This type of diagnosis requires additional
investigation because the sample has abnormal
characteristics. This lesion should be biopsied
with a more complete method to determine
whether a malignancy (cancer) is present.
Malignant - a diagnosis of cancer;
should be biopsied and tested for exact
tumor makeup to prepare for
treatment.
Unsatisfactory - a diagnosis cannot be
determined from the sample because
of insufficient sample size, processing
or other machine or human errors.
Examination of Tissue
Samples
Immunohistochemistry (IHC)
Fluorescence in Situ
Hybridization (FISH)
Immunohistochemistry (IHC)
Is a technique used to determine the
presence and level of specific cellular
proteins.
External
External Beam Radiation Therapy
3-D Conformal Therapy and Intensity
Modulated Radiation Therapy (IMRT)
Benefits
Destroys quickly dividing cells at the
margins of tumors. Surgery may miss these
cells leading to recurrence of disease.
Can successfully eradicate growth without
permanently damaging the adjacent normal
tissue. If these tumors can be treated early before
metastasis, there is a very high rate of curability.
In conjunction with other treatments, may
cure tumors that are not responsive to any
single agent.
Hormonal Treatments
Is to cure malignancy
Control maybe the goal when cure is
not realistic; the aim is to extend
survival and improve the quality of
life.
Palliation may be the goal when
neither cure nor control maybe
achieved; this goal is directed toward
client comfort.
Types of Chemotherapy
Drugs
Antimetabolites
Genotoxic Drugs
Spindle Inhibitors
Other Chemotherapy Agents
Anti- Metabolites
Purine Antagonists
Pyrimidine Antagonists
Folate Antagonist
Enzyme inhibitors
These drugs inhibit key enzymes, such as
topoisomerases, involved in DNA
replication inducing DNA damage.
Spindle Inhibitors
Vinca Alkaloids
Paclitaxel (Taxol®)
Docetaxel (Taxotere®)
Ixabepilone (Ixempra®)
Additional
While many of the Chemotherapy
commonly used
Agents
chemotherapy agents fit into one of the
three previously described groupings
(Genotoxic, Cytoskeletal, and Anti-
metabolite), some of them work through
mechanisms that do not neatly fit into one of
these categories.
Arsenic trioxide (Trisenox®)
Bleomycin
Hydroxyurea
Streptozocin
Chemotherapeutic
Administration
Oral
IM/ SQ
IV
Central Venous Catheter
Venous Access Devices (VAD)
Intraarterial Route
Intraperitoneal Route