Interactive Session 2
December 8 t h , 2023
A) The first medical imaging technique that will likely be used is mammography, which is a standard
screening method for detecting breast abnormalities, especially lumps or masses.
B) The biopsy is typically performed using ultrasound guidance. A small tissue sample is taken from
the abnormal area using a needle, and this sample is sent for histological examination. Histological
confirmation means that the tissue sample is analyzed under a microscope to determine the nature
of the cells, confirming whether they are cancerous or not.
Size: ultrasound
Axillary metastases (lymph nodes): ultrasound
Invasive: histology
C) The pathological TNM stage based on the given details, it could be at least T1N1M0:
T1 (Tumor size): 1.5 cm invasive ductal carcinoma.
N1 (Regional lymph nodes): Sentinel lymph node contains a metastasis.
M0 (Distant metastasis): No distant metastases found.
Sentinel lymph node procedure: remove nearby lymph nodes.
D) Common distant metastatic sites for breast cancer include bones, liver, and lungs.
E) Positron Emission Tomography (PET) can be used for imaging breast cancer metastases. 18F-FDG
PET is commonly used, and it involves injecting a radiolabeled glucose analog (18F-FDG) into the
body. Cancer cells, which are often more metabolically active than normal cells, take up more of the
labeled glucose, allowing their detection on the PET scan.
F) Radiotherapy involves using high-energy rays or particles to kill or damage cancer cells. It works by
damaging the DNA inside cells, preventing them from growing and dividing.
G) The purpose of radiotherapy in this case is likely to target any remaining cancer cells in the breast
or surrounding tissues after the surgery, reducing the risk of recurrence.
H) Hypoxia (low oxygen levels) in a tumor can make it more resistant to radiation therapy because
oxygen is essential for the effectiveness of radiation in damaging DNA.
I) Chemotherapy involves using drugs to kill or slow the growth of rapidly dividing cells, including
cancer cells. It is a systemic treatment, meaning it circulates throughout the body.
J) The maximum tolerated dose is the highest dose of a drug that can be given without causing
unacceptable side effects.
K) Assessing ER status throughout the body with 18F-FES PET can be useful to detect potential
metastases expressing estrogen receptors. This information can guide treatment decisions and
monitor the response to therapy. Technique could also be used to follow the treatment. Metastasis
would disappear over time.
December 8 t h , 2023
A) The first medical imaging technique that will likely be used is mammography, which is a standard
screening method for detecting breast abnormalities, especially lumps or masses.
B) The biopsy is typically performed using ultrasound guidance. A small tissue sample is taken from
the abnormal area using a needle, and this sample is sent for histological examination. Histological
confirmation means that the tissue sample is analyzed under a microscope to determine the nature
of the cells, confirming whether they are cancerous or not.
Size: ultrasound
Axillary metastases (lymph nodes): ultrasound
Invasive: histology
C) The pathological TNM stage based on the given details, it could be at least T1N1M0:
T1 (Tumor size): 1.5 cm invasive ductal carcinoma.
N1 (Regional lymph nodes): Sentinel lymph node contains a metastasis.
M0 (Distant metastasis): No distant metastases found.
Sentinel lymph node procedure: remove nearby lymph nodes.
D) Common distant metastatic sites for breast cancer include bones, liver, and lungs.
E) Positron Emission Tomography (PET) can be used for imaging breast cancer metastases. 18F-FDG
PET is commonly used, and it involves injecting a radiolabeled glucose analog (18F-FDG) into the
body. Cancer cells, which are often more metabolically active than normal cells, take up more of the
labeled glucose, allowing their detection on the PET scan.
F) Radiotherapy involves using high-energy rays or particles to kill or damage cancer cells. It works by
damaging the DNA inside cells, preventing them from growing and dividing.
G) The purpose of radiotherapy in this case is likely to target any remaining cancer cells in the breast
or surrounding tissues after the surgery, reducing the risk of recurrence.
H) Hypoxia (low oxygen levels) in a tumor can make it more resistant to radiation therapy because
oxygen is essential for the effectiveness of radiation in damaging DNA.
I) Chemotherapy involves using drugs to kill or slow the growth of rapidly dividing cells, including
cancer cells. It is a systemic treatment, meaning it circulates throughout the body.
J) The maximum tolerated dose is the highest dose of a drug that can be given without causing
unacceptable side effects.
K) Assessing ER status throughout the body with 18F-FES PET can be useful to detect potential
metastases expressing estrogen receptors. This information can guide treatment decisions and
monitor the response to therapy. Technique could also be used to follow the treatment. Metastasis
would disappear over time.
