BREAST

Question 1

what percentage of breast cancer occurs in men?

Answer 1

<1%

Question 2

DCIS is a precursor of invasiveness in the ____ breast

Answer 2

ipsilateral

Question 3

is LCIS a premalignant change?

Answer 3

no

Question 4

LCIS is a marker for…

Answer 4

increased risk of development of malignancy in either breast

Question 5

most common breast cancer?

Answer 5

invasive ductal carcinoma

Question 6

what percent of DCIS progress to invasive ductal carcinoma if left?

Answer 6

50%

Question 7

how is DCIS treated?

Answer 7

• wide local excision with clear margins and radiotherapy

- masectomy for large lesions or multicentric disease

Question 8

how many grades of DCIS is there?

Answer 8

1-3 (according to the nuclear atypia and tubule differentiation)

Question 9

what percentage of breast cancers express hormone receptors?

Answer 9

70%

Question 10

what does mammogram of DCIS show?

Answer 10

microcalcifications

Question 11

what is triple assessment?

Answer 11

clinical
radiological
pathological

Question 12

downside of FNA?

Answer 12

-doesnt differentiate between invasive and non-invasive

Question 13

uses of core needle biopsy?

Answer 13

-tells you receptor status, differentiates between carcinoma in situ and invasive carcinoma

Question 14

when is wire guided open excision biopsy used?

Answer 14

when a core needle biopsy fails

Question 15

What does TNM stand for?

Answer 15

TUMOR
NODES
METASTASIS

Question 16

Tis

Answer 16

Tumour in situa

Question 17

T0

Answer 17

No primary tumour located

Question 18

T1

Answer 18

Tumour < 2cm

Question 19

T2

Answer 19

Tumour 2-5 cm

Question 20

T3

Answer 20

Tumour > 5 cm

Question 21

T4

Answer 21

Tumour extends to chest wall

Question 22

N0

Answer 22

no nodes involved

Question 23

N1

Answer 23

mobile ipsilateral axillary nodes

Question 24

N2

Answer 24

fixed ipsilateral axially nodes

Question 25

N3

Answer 25

ipsilateral supraclavicular nodes

Question 26

M0

Answer 26

no metastasis

Question 27

M1

Answer 27

distant metastasis

Question 28

types of breast reconstruction following masectomy?

Answer 28

implant reconstruction

autologus reconstruction

Question 29

types of autologus reconstruction

Answer 29

free flap - DIEP

pedical flap - lattismus dorsi flap

Question 30

if a sentinal node is positive what is the next step?

Answer 30

axillary clearance of all lymph nodes

Question 31

which nerve is at risk during axillary node clearance?

Answer 31

long thoracic nerve

thoracodorsal nerve

Question 32

common complications of axillary node clearance?

Answer 32

• axillary numbness

- lymphedema in arm

Question 33

Where are the 3 levels of axillary node clearance?

Answer 33

lateral to and medial to and behind the pec muscles

Question 34

what is tamoxifen?

Answer 34

SERM

Question 35

who is treated with tamoxifen?

Answer 35

ER+ premenopausal patients

Question 36

what is anastrazole?

Answer 36

-aromatase inhibitor

Question 37

who is treated with anastrazole?

Answer 37

-ER+ postmenopausal patients

Question 38

what is herceptin (trastuzamab)?

Answer 38

antibody directed at HER2 (in HER+ patients)

Question 39

what is lapatinib?

Answer 39

a tyrosine kinase inhibitor for EGFR and HER2

Question 40

what is an oncotype dx test?

Answer 40

a test that analyzes 21 genes to determine prognostic factors and whether a patient with early stage breast cancer would benefit from chemo

Question 41

dx of fibroadenoma?

Answer 41

ultrasound followed by core biopsy

Question 42

what is a fibroadenoma made of?

Answer 42

breast, epithelial and fibrous tissue

Question 43

diagnosis of breast cyst?

Answer 43

FNA, mammography to rule out malignancy

Question 44

treatment of fibrocystic disease

Answer 44

evening primrose oil to releive discomfort

Question 45

most common cause of gynecomastia in young males

Answer 45

cannabis

Question 46

most common cause of gynecomastia in older males

Answer 46

spironolactone