BREAST Flashcards
what percentage of breast cancer occurs in men?
<1%
DCIS is a precursor of invasiveness in the ____ breast
ipsilateral
is LCIS a premalignant change?
no
LCIS is a marker for…
increased risk of development of malignancy in either breast
most common breast cancer?
invasive ductal carcinoma
what percent of DCIS progress to invasive ductal carcinoma if left?
50%
how is DCIS treated?
- wide local excision with clear margins and radiotherapy
- masectomy for large lesions or multicentric disease
how many grades of DCIS is there?
1-3 (according to the nuclear atypia and tubule differentiation)
what percentage of breast cancers express hormone receptors?
70%
what does mammogram of DCIS show?
microcalcifications
what is triple assessment?
clinical
radiological
pathological
downside of FNA?
-doesnt differentiate between invasive and non-invasive
uses of core needle biopsy?
-tells you receptor status, differentiates between carcinoma in situ and invasive carcinoma
when is wire guided open excision biopsy used?
when a core needle biopsy fails
What does TNM stand for?
TUMOR
NODES
METASTASIS
Tis
Tumour in situa
T0
No primary tumour located
T1
Tumour < 2cm
T2
Tumour 2-5 cm
T3
Tumour > 5 cm
T4
Tumour extends to chest wall
N0
no nodes involved
N1
mobile ipsilateral axillary nodes
N2
fixed ipsilateral axially nodes
N3
ipsilateral supraclavicular nodes
M0
no metastasis
M1
distant metastasis
types of breast reconstruction following masectomy?
implant reconstruction
autologus reconstruction
types of autologus reconstruction
free flap - DIEP
pedical flap - lattismus dorsi flap
if a sentinal node is positive what is the next step?
axillary clearance of all lymph nodes
which nerve is at risk during axillary node clearance?
long thoracic nerve
thoracodorsal nerve
common complications of axillary node clearance?
- axillary numbness
- lymphedema in arm
Where are the 3 levels of axillary node clearance?
lateral to and medial to and behind the pec muscles
what is tamoxifen?
SERM
who is treated with tamoxifen?
ER+ premenopausal patients
what is anastrazole?
-aromatase inhibitor
who is treated with anastrazole?
-ER+ postmenopausal patients
what is herceptin (trastuzamab)?
antibody directed at HER2 (in HER+ patients)
what is lapatinib?
a tyrosine kinase inhibitor for EGFR and HER2
what is an oncotype dx test?
a test that analyzes 21 genes to determine prognostic factors and whether a patient with early stage breast cancer would benefit from chemo
dx of fibroadenoma?
ultrasound followed by core biopsy
what is a fibroadenoma made of?
breast, epithelial and fibrous tissue
diagnosis of breast cyst?
FNA, mammography to rule out malignancy
treatment of fibrocystic disease
evening primrose oil to releive discomfort
most common cause of gynecomastia in young males
cannabis
most common cause of gynecomastia in older males
spironolactone
