Screening (American Cancer Society): Average Risk: 40 - 44 years old: have the option to start screening with a mammogram every year. 45 - 54 years old: should get mammograms every year. 55 and older: Can switch to a mammogram every other year, or they can choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and is expected to live at least 10 more years. High Risk: Definition: Women with lifetime risk of breast cancer of 20% or

Gallbladder Cancer Background: Most common biliary tract malignancy (~80–95% of all biliary tract cancers) yet it remains relatively rare. ~3 times more common in women Incidence increases with age (peak 70–75 years) Symptoms are often indistinguishable from cholelithiasis/cholecystitis. ~50% of cases are discovered incidentally on post-cholecystectomy pathologic review Risk factors: Cholelithiasis, obesity chronic Infections (Salmonella typhi, Helicobacter species), chronic

Chondrosarcoma Background: Most common bone cancer in adults (40%) Most frequent sites of origin: Pelvis and proximal femur Characterized by malignant cartilage matrix production without osteoid Bony destruction + calcification Very chemoresistant Subtypes: Conventional (90%) Non-conventional (10%) Clear cell Dedifferentiated Mesenchymal Myxoid Juxtacortical Treatment: Conventional chondrosarcoma: Wide surgical excision with negative margins Consider radiation therapy for: Bo

Types: Urothelial carcinoma/ Transitional cell (90%) Risk Factors: Occupational exposures (dye manufacturers, rubber aluminum factories), smoking SCC of the bladder (5%) Associated with chronic inflammation (schistosoma, chronic UTI, chronic foley use) Treatment: Surgery Adenocarcinoma of bladder (2%) Treatment: Cystectomy Small cell bladder cancer (1%) Treatment: Cisplatin + Etoposide (like regimen for SCLC) → RT or cystectomy Plasmacytoid: Associated with CDH1 gene mutatio

Introduction: NHL is categorized into two groups of B-cell lymphomas and T/NK-Cell lymphomas: B-cell lymphomas (85–90%): Aggressive: Diffuse large B-cell lymphoma (DLBCL) High-grade B-cell lymphoma (HGBL) Includes selected lymphomas with MYC and BCL2 rearrangements Historically referred to as “double-hit” lymphoma when MYC and BCL2 rearrangements are present Burkitt lymphoma (BL): Highly aggressive Derived from germinal center B cells Mantle cell lymphoma (MCL): Generally cli

Background: Proliferation of immature myeloid blasts with differentiation arrest The median age at diagnosis is late ~60s May present with pancytopenia, hyperleukocytosis (>100K), leukostasis, DIC, TLS Symptoms of leukostasis: Lung: SOB, DAH, respiratory failure CNS: Confusion, coma, delirium, focal neurologic deficits Eye: Impaired vision, retinal hemorrhage Vascular: Priapism Work up: Peripheral blood: CBC with diff, PBS, coagulation panel (DIC risk in APL) BMBx: A marrow o

Background: Risk factor: HPV (high risk) > HIV, smoking Mostl y SCC Work-up: DRE Anoscopy LN biopsy/FNA HIV test Chest/abd CT scan Staging: T1: ≤ 2cm T2: 2-5 cm T3: > 5cm T4: Any tumor size invaded to adjacent organs Perianal SCC Non-metastatic disease (M0): Local excision/surgery: Indications: T1 N0 well/moderately differentiated T2 N0 with no sphincter involvement ChemoRT: Indications: T1 N0 poorly differentiated T2-4 N0 Any T N+ ChemoRT can cure without requiring an abdomi

Vitamin K antagonist (VKA): Warfarin Mechanism: Inhibit hepatic synthesis of vitamin K–dependent clotting factors (II, VII, IX, X) Decreases proteins C and S Eliminated by hepatic metabolism Requires close INR monitoring INR interpretation may be challenging in significant hepatic dysfunction because liver disease can elevate the baseline INR Consider if other agents are contraindicated Direct oral anticoagulants (DOAC): Classes: Direct thrombin (IIa) inhibitors Dabigatran Di

Anemia of chronic disease: Mediated by IL-6 Promotes hepcidin expression → decreased intestinal absorption and storage of ferritin in macrophages Transferrin downregulated Erythropoiesis becomes iron restricted (since iron not accessible) May eventually lead to iron deficiency due to lack of GI absorption Hemolytic anemia (Separate section below) Iron deficiency anemia (Separate post "Iron Metabolism and Diseases") Iron refractory iron deficiency anemia (IRIDA): Inherited or

Anthracyclines: Myelosuppression (esp neutropenia ) Nausea, vomiting Total alopecia Mucositis Red-colored urine Cardiomyopathy (mostly with Doxorubicin, risk increases with cumulative dose) Secondary malignancies (AML, MDS) Topoisomerase I inhibitors: Irinotecan: Severe diarrhea , nausea, vomiting Neutropenia Top otecan: Myelosuppression Less GI toxicity Interstitial lung disease (rare but serious) Topoisomerase II inhibitors: Doxorubicin: Discussed in Anthracyclines secti

Background: Second most common acute leukemia in adults 75% of cases are B-cell lineage, 25% are T-cell lineage Diagnosis requires ≥20% bone marrow lymphoblasts Work up: CBC with diff, CMP, LFT DIC panel TLS panel Hepatitis B/C and HIV serologies BMBx: Cytogenetics, Molecular analyses To identify if philadelphia chromosome/ philadelphia-like chromosome is present Philadelphia-like chromosome: Lacks the BCR-ABL1 gene Associated with poor prognosis Consider use of TKIs and earl