B8.039 Prework 5: Clinical Aspects of Breast Cancer

Question 1

how to screen women with extremely dense breasts

Answer 1

masses difficult to detect

alternative screening with MRI or US may be appropriate

Question 2

levels of breast density

Answer 2

1 = <25%
2 = <50%
3 = >50%
4 = >75%

Question 3

benign lesions on mammography

Answer 3

well circumscribed

Question 4

suspicious masses on mammography

Answer 4

dense, spiculated

Question 5

ductal carcinoma on mammography

Answer 5

pleomorphic calcifications in a branching, ductal distribution

Question 6

derivation of breast tissue

Answer 6

glandular structure

-modified aprocrine sweat gland

Question 7

borders of breast

Answer 7

2-3rd and 6-7th rib
lateral sternum to anterior axillary line
deep to fascia of pectoralis major muscle

Question 8

largest breast tissue volume

Answer 8

upper outer quadrant

most common site of malignancy

Question 9

lymphatic drainage of the breast

Answer 9

internal mammary nodes
supraclavicular nodes
axillary nodes

Question 10

muscle that defines the axillary lymph nodes

Answer 10

pec minor

Question 11

buzzwords for malignant breast tumors

Answer 11

axillary lymph node involvement most important prognostic factor
most often in upper outer quadrant

Question 12

buzzwords for DCIS

Answer 12

microcalcifications

Question 13

buzzwords for comedocarcinoma

Answer 13

central necrosis

Question 14

buzzwords for paget

Answer 14

underlying DCIS or invasive cancer

eczematous patches on nipple

Question 15

buzzwords for invasive ductal carcinoma

Answer 15

firm, fibrous, rock hard, sharp margins
worst, most invasive
most common

Question 16

buzzwords for invasive lobular

Answer 16

orderly row of cells
loss of e cadherin
bilateral

Question 17

buzzwords for inflammatory carcinoma

Answer 17

orange peel skin

block lymphatic drainage

Question 18

surgical options for breast cancer

Answer 18

partial mastectomy
simple mastectomy
modified radical mastectomy
radical mastectomy

Question 19

partial mastectomy

Answer 19

removal or tumor and small rim around it
2 mm margins ideal
often paired with radiation

Question 20

simple mastectomy

Answer 20

removal of all glandular tissue of breast

NOT lymph nodes

Question 21

modified radical mastectomy

Answer 21

entire breast is removed as well as the underarm lymph nodes

chest muscles intact

Question 22

radical mastectomy

Answer 22

complete removal of breast, including the nipple, overlying skin, muscle beneath breast, and lymph nodes
rarely performed

Question 23

core needle biopsy

Answer 23

assesses axillary lymph node for tumor markers

Question 24

sentinel lymph node biopsy

Answer 24

blue dye injected into breast parenchyma
dye will drain along same channels as tumor cells
only nodes that take up the dye are assessed pathologically

Question 25

anesthesia drugs

Answer 25

propofol
midazolam
fentanyl
hyoscine patch
famotidine

Question 26

oncotype DX

Answer 26

21 gene assay

assesses estrogen, HER2, proliferation, invasion, and reference genes to determine recurrence risk of BC

Question 27

doxorubicin MOA

Answer 27

generates free radicals

intercalate in DNA > breaks in DNA > decreased replication

Question 28

cyclophosphamide MOA

Answer 28

cross link DNA at guanine

Question 29

paclitaxel MOA

Answer 29

hypestabilize polymerized microtubules in M phase so that mitotic spindle cannot break down