Module 2 focuses on breast cancer treatment and therapies. The main aim of this module is to deepen participants` knowledge on different treatment methods used either as definite treatment or combination of treatments beginning with the factors that underpin the approach chosen. Learner will also gain knowledge of breast cancer treatment related acute reactions by their common signs and symptoms and management of metastatic breast cancer. The module consists of the following sub-topics: Principles of breast cancer diagnosing, treatment intent and appropriate treatment methods, surgery, systematic anticancer therapies, radiotherapy, treatment related emergencies, management of metastatic breast cancer.

After successful completion of the module, the learner is expected to be able to:

TopicKnowledgeSkillsCompetence
Principles of breast cancer diagnosing, treatment intent and appropriate treatment methodsDemonstrate advanced knowledge of the principles  underpinning the definitive diagnosis (BL tests, diagnostic imaging) of breast cancer, treatment intent and treatment methods most appropriate for the breast cancer type and characteristicsArgument the need for multidisciplinary team decision making in breast cancer treatmentIdentify the professionals needed in BC multi-disciplinary team meeting. Select proper laboratory tests for breast cancer typing and definitive diagnosis and argue appropriate (multimodality) treatment regimen according to the tumour characteristics e.g TNM, hormonal receptor status etc. 

Surgery
Demonstrate advanced knowledge of the indications and factors for primary surgery in breast cancer. The principles of breast cancer surgery including reconstruction and post-operative management
Predict the complications of BC surgery procedures. Argument the procedures in the care of breast cancer patient (surgical ward) 
as well as recognize possible mental symptoms after surgery (anxiety, depression)
psychosocial support changes in body image and sexuality
Distinguish and understand suitable surgical option for breast.
Explain the surgery procedures, patient care and management of complications
Systemic anticancer therapiesDemonstrate critical understanding of principles of breast cancer systemic anticancer therapies (SACT) (targeted therapy, hormonal therapy, radiotherapy). Preparation and safe handling and administration of SACT as well as anatomical and physiological principles for administration and side-effects of SACT. 

Name key aspects of informed consent form and legislation of administration of SACT 
Select appropriate assessment tools for toxicities.
Refer patient to and involve other healthcare providers.
Perform pre-treatment assessments and has  evidence based knowledge of indications for medical examination, patient assessment and education.
Apply pre-treatment assessment, patient education and legislation aspects of SACT. 
Identify SACT according to mode of action, scheduling principles, delivery and contradictions as well as short and long term side effects and toxicities associated with SACTs.
Explain safe handling and reconstitution of medicines: equipment handling and disposal, 
correct technique, infection control and management of spillage
Radiotherapy Demonstrate critical understanding of the basics of physical principles in relation to radiotherapy (Ionizing radiation, exposure, dose). Concept of BC external beam and radiotherapy brachytherapy treatment planning process (simulation, contouring, volumes, dosimetry) and daily treatment, including common side-effects and their managementChoose and argument appropriate immobilization method for BC radiotherapy. Understand the principles of choosing treatment technique/method (DIBH, 3D, IMRT)
Be able to assess and treat side-effects, counsel the patient in self-management of side-effects using assessment tools for breast cancer patient (e.g RTOG) 
Refer to other healthcare specialists (acute skin reactions or other).
Formulate and justify BC radiotherapy treatment protocol including all aspects of treatment planning, daily treatment (incl. positioning and verification) and side-effects management. 
Treatment related emergencies Demonstrate advanced knowledge of breast cancer treatment related emergencies (reactions to treatment) by the signs/symptomsUse evidence-based interventions to assess, prevent and assist in the management of emergencies caused by cancer therapiesApply appropriate intervention strategy for an emergency case described
Management of metastatic breast cancer Demonstrate advanced knowledge of metastatic breast cancer management and patient supportArgument the difference of treatment pathway compared to early and locally advanced (I-III) stages 
Explain the purpose of treatment in palliative setting (to ease the symptoms and pain and prolong life)
Procedures and support during treatment pathwayDemonstrate advanced knowledge of laboratory test taken during breast cancer treatment pathway as well as the ways to support the patients psychosocially.Argument the aspects of different laboratory test taken during BC treatment pathway. Use the knowledge of psyhcosocial support options to assist the patients and their families.