MT Training > Cancer Medicine

V. Combining Forms, Suffixes, and Prefixes, and Terminology

Combining Forms

VI. Practical Application

The Philadelphia Chromosome

The Philadelphia chromosome is found in the malignant cells of patients with chronic myelogenous leukemia. In these cells, chromosome 22 is unusually short, as though the end had broken off. The missing genetic material is usually found attached to chromosome 9. The shortened chromosome is referred to as the Philadelphia chromosome because it was first documented by researchers in those city.

Case Report

A 52-year-old married woman presented to her physician with a painless mass in her left breast. During breast examination a 2-cm, from, nontender mass was palpated in upper outer quadrant located at 2’oclock position, 3 cm from the areola. The mass was not fixed to skin, and there was no cutaneous erythema or edema. No axillary or supraclavicular lymphadenopathy was noted.

An excisional biopsy of the mass was performed. The pathology report described a gross specimen of fatty breast tissue. Microscopic evaluation of the nodule revealed a scirrhous carcinoma. The margins of the excision were free of tumor. Axillary dissection of lymph nodes was performed and all 12 nodes were free of tumor.

A portion of the specimen was sent for estrogen receptor assay and proved positive. The patient was informed of the diagnosis and underwent additional studies, including chest x-ray, liver chemistries. CBC, and bone scan-all of which were negative.

The patient was staged as having a T1NoMo, stage 1 carcinoma of the left breast. She was referred to a radiation therapist for primary radiation therapy. After completion of radiotherapy, she was treated with tamoxifen. Prognosis is excellent for cure.

Questions for the Case Report

1.      Where was the breast lesion located?

a)      under the pigmented area of the breast

b)      about an inch and a half to the upper left of the nipple and pigmented area

c)      near the axilla and under the shoulder blade

2.      Other associated findings were

a)      redness and swelling

b)      enlarged lymph nodes under the armpit

c)      none of the above

3.      The tumor was composed of

a)      dense connective tissue giving it a hard structure

b)      soft, glandular tissue

c)      removal of lymph nodes under the arm

4.      What procedure gave evidence that the tumor had not yet metastasized?

a)      estrogen scan liver chemistries, CBC and the chest x-rays

b)      radiation to the breast

c)      removal of lymph nodes under the arm

5.      What additional therapy was undertaken?

a)      bone scan liver chemistries, CBC and the chest x-rays

b)      radiation to the breast

c)      radiation to the breast and hormonal treatment

6.      Tamoxifen was prescribed because

a)      the tumor was found to be nonresponsive to estrogen

b)      the tumor was found to be responsive to estrogen and tamoxifen is an antiestrogen

c)      the tumor was a stage 1 carcinoma

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