Breast Flashcards
1
Q
The lower pole of the breast can
be constricted in patients with macromastia or mild tuberous breast deformity true or false?.
A
The lower pole of the breast can
be constricted in patients with micromastia or mild tuberous breast
deformity.
2
Q
Symmastia occurs more in subglandular or submuscular ?
A
Symmastia occurs more in subglandular
3
Q
Different types of selecon rupture can detect with US?
A
Silicone ruptures with cohesive gel implants can be detected on a mammogram
but more often require MRI to confirm a suspected rupture
4
Q
Textured devices have lower rates
of capsular contracture, in SUBMASCULAR?
A
Textured devices have lower rates
of capsular contracture when a textured implant is placed in a subglandular or subfascial
plane
5
Q
What the percentage of capsular contracture?
A
Capsular contracture rates from long-term studies
demonstrate variability based on implant manufacturer
6
Q
what the suitable size of areola to do transareolar approach ?
A
Good access if diameter of areola is >3.5 cm
7
Q
what nerve that can injured with transaxlary approach ?
A
Avoid deep dissection in axilla; intercostobrachial and medial brachial cutaneous nerves are vulnerable
8
Q
percentage of contracture with breast augmentation ?
A
Subglandular: 32% contracture rate
Subpectoral: 12% contracture rate
9
Q
I s there is any change in the sensatin of the nipple after breast implant ?
A
15% of patients
10
Q
what the waterfall deformity in breast augmentation? Double-bubble deformity type A
A
Implant is held high on chest wall by total pectoral coverage or contracture, and loose parenchyma slides off pectoral muscles inferior to axis of the implant
The dual-plane approach helps to prevent this deformity
11
Q
The biopurden of BIA-ALCL more with smooth or textured Implants?
A
Textured
12
Q
Nipple sensation is equally likely to be preserved with submuscular or subglandular implant placement.?????
A
Nipple sensation is usually preserved following breast augmentation but it is more likely to be preserved
with submuscular placement because the fourth intercostal nerve runs within the pectoralis fascia
13
Q
Peri areolar mastopexies can be used to elevate the nipple
A
no more than 2 cm with an eccentrically designed oval.
14
Q
can we make breast augmentation with SPAIR MASTOPEXY ?
A
NO but we can use it in hall-findllay technique
15
Q
mastopexy technique can that reliably leads to
signifi cantly increased upper poll fullness in the long term?
A
This is because there is no mastopexy technique that reliably leads to significantly increased upper pole fullness in the long term
16
Q
what is the drawback of Periareolar mastopexies?
A
Removing skin in a concentric pattern can, however, flatten and reduce breast projection.
Scar widening and eventual widening of the areola can occur If there is circumferential full thickness violation of the
dermis, decreased nipple sensitivity may occur.
17
Q
vertical mastopexy can used for all grade of breast ptosis?
A
T
18
Q
what the primary blood supply to the breast?
A
The primary blood supply originates from the internal mammary system and its arteries perforate the breast from deep to superficial.
19
Q
what is the is the lymphatic drainage of the breast ?
A
cutaneous, internal mammary, posterior intercostal, and axillary routes
20
Q
After SUCTION-ASSISTED LIPECTOMY the patients alaways need mastopexy?
A
F may include
mastopexy after successful SAL
21
Q
keloid scarring is a common complication in breast surgery
A
keloid scarring is a rare complication in breast surgery
22
Q
Nipple sensation precerved with submascula approuch better T or F
A
Nipple sensation is usually preserved following breast augmentation but it is more likely to be preserved with submuscular placement because the fourth intercostal nerve runs within the pectoralis fascia
23
Q
How many the incidence of revision after augmentation-mastipexy?
A
Augmentation-mastopexy techniques are associated with high revision rates of up to one in five, although this may be reduced to less than 1 in 10 by staging the procedure
24
Q
What the indication of tow stage AUGMENTATION-MASTOPEXY
A
Breast asymetry
Vertical access mor than 6 cm
SN to NAC more than 30
25
Neurofibromatosis 1 associated with syndromic breast cancer
T
26
Local recurrence rates after SSM are more than to other forms of mastectomy.
Local recurrence rates after SSM are similar to other forms of mastectomy.
27
Smoking was found to be an independent risk factor for implant loss in prosthetic reconstruction.5
F large mastectomy specimen weight was found to be an independent risk factor for implant loss in prosthetic reconstruction.5
28
How much the obese patients develop risk of breast implant reconstruction vs no obese ?
patients with BMI >30 were almost seven times more likely to experience reconstructive failure following prosthetic reconstruction than their nonobese counterparts
29
Macromastia contraindication for breast prosthetic reconstructions
macromastia is not a contraindication to implant-based reconstruction
30
The most important parameter in choosing the expander type is the shape of expander?
Among these, base width is the most important parameter for intraoperative device selection
matching the device base mdth to the mdth of the breast footprint on the chest wall eliminates dead space and skin redundancy while optimizing the final expansion pocket
31
All currently available anatomic-shaped implants are also textured T or F
T All currently available anatomic-shaped implants are also textured to limit unwanted implant movement/ rotation;
32
capsular contracture and reconstructive failure appear to be two to three times more likely in previously irradiated patients. T or F
T
33
The ADM can be used before prosthetics reconstraction for irradated tissue to decrease the complication rate?
the use of ADM in previously irradiated patients is not protective against reconstructive failure and may increase the rate of skin flap and infectious complications
34
Undergoing chemotherapy treatment increase the incidence complication rates in patients undergoing prosthetic reconstruction
there is no clear evidence that either neoadjuvant or adjuvant chemotherapy increases complication rates in patients undergoing prosthetic reconstruction
35
Preoperative imaging may elucidate vessel anatomy, but is not always critical. in breast autologus reconstraction
T
36
The need of radiation after mastectomy is absolute contraindication for early reconstruction of the breast?
The need for PMRT, though not an absolute contraindication to immediate reconstruction, tends to be the predominant reason to consider delayed reconstruction
37
Active smoking would be a absolute contraindication for performing any autologous flap procedure with increased risk for wound dehiscence and delayed wound healing
F. Active smoking would be a relative contraindications
38
Perfusion of flaps based on the SIEA/SIEV is reliable across the midline.
Perfusion of flaps based on the SIEA/SIEV is not reliable across the midline.
39
Preoperative imaging may elucidate vessel anatomy, but it is always critical for brest flap reconstruction
Preoperative imaging may elucidate vessel anatomy, but is not always critical
40
Clinical exam remains the standard for postoperative flap monitoring. T or F
T
41
history of h ypercoagulable conditions would be a contraindication to performing a free tissue and pedicled flap options ,
history of h ypercoagulable conditions would be a contraindication to performing a free tissue transfer with an increased risk for vessel thrombosis; pedicled flap options would be possible in this context
42
Studies have shown that CTA may reduce operative time in abdomenal based breast reconstruction T or F
T
43
the deep inferior epigastric artery system is the more dominant blood supply to the abdominal skin and fat,and muscle
F. the deep inferior epigastric artery system is the more dominant blood supply to the abdominal skin and fat,
44
Free abdominal based flap for breast has short pedicle with similar caliper for IMA
a long pedicle with similar caliber to recipient vessels
45
Perfusion of flaps based on the SIEA/SIEV is reliable across the midline.
Perfusion of flaps based on the SIEA/SIEV is not reliable across the midline.
46
primary closure without mesh is often possible with DIEP flap and free TRAM flap harvests
F. primary closure without mesh is often possible with DIEP flap and free ms-TRAM flap harvests
47
Free TRAM harvests tend to include wide sections of anterior rectus fascia and always require mesh placement, particularly in cases with bilateral flaps.
F. Free TRAM harvests tend to include wide sections of anterior rectus fascia and may require mesh placement, particularly in cases with bilateral flaps.
48
Vertical upper gracilis (VUG) has more reliable skin peddle
transverse upper gracilis (TUG) has more reliable skin peddle
49
The pedicles of upper thigh flap is identified in the interval between the gracilis and adductor magnus muscles
The pedicles of upper thigh flap is identified in the interval between the gracilis and adductor magnus muscles
50
The pedicles of posterior thigh flap located 10 cm below to the gluteal crease
Perforators from the pedicle are located roughly 5 to 6 cm below the5gluteal crease
51
The flap is designed as a horizontal ellipse with superior incision at the gluteal crease
The flap is designed as a horizontal ellipse with superior incision at or immediately below the gluteal crease
52
A contralateral composite nipple graft can be considered for patient who has a nibble projection of 10 to 15 mm
This technique is most effective in patients with a large contralateral nipple where projection exceeds 5 to 6 mm
53
composite nipple grafting can provide sensation and erectile function in the reconstructed nipple in some cases
T
54
The breast is not functional after birth to puberty. Is it true or false?
At birth, the neonatal mammary tissue is functional. Seventy percent may secrete colostrum because of rise in prolactin. The nipples evert soon after birth because of proliferation of the underlying mesoderm.
55
The lactiferous tissue tissue will be completed at eight week. Is it true or false?
True
56
There is no genetic relationship in bilateral absence of the breast
Genetically inherited bilateral absence of the breast has been described
57
Mandrekas expanded on this with a ring theory regarding tuberous breast, result from thickening of deep facia of the deep fascia
Fals superficial fascial not deep
58
How many patients with tuberous breast require breast expansion
8% of total or 30% of Groleau type III tuberous breast required expansion.
59
Poland syndrome most common in female commonly left side ?
Male 3:1 female commonly right side in female it equal in right and left
60
how much is the percentage of Poland syndrome in female breast aplasia?
Poland syndrome is involved in 14% of
breast aplasia.
61
How much the percentage of poland syndrome patients whom has hand anomalies?
The frequency of hand abnormalities with Poland syndrome is 13.5% to 56%; in turn, 10% of syndactyly is a result of Poland syndrome
62
How many the percentage of chest anamoly in poland syndrom ?
Aplasia of the ribs and cartilage involving rib segments two to five often leads to severe chest depression in 11% to 25% of patients
63
Percentage of patients whom hase lung hernaition in poland
Eight percent of patients may have lung herniation
64
Renal ultrasounds are recommended for all patients with aplasia of the pectoralis
T
65
Breast cancer does not appear in poland syndromes apatients on the effected side ?
breast cancer has been reported to occur in patients with Poland syndrome and therefore standard monitoring is required.
66
Lipofilling in poland syndrom can be used without any implants with sufficient result
Lipofilling can also be used to camouflage chest abnormalities and may obviate the need for custom silicone devices
67
There is a role to use ADM with breast implant in poland ?
there have been no descriptions of use of ADM to secure the implant and to reduce the incidence of capsular contracture in Poland syndrome.
68
The most common form of breast reconstruction in poland syndrom is using prosthetic device?
The pedicled latissimus dorsi flap in combination with a prosthetic device has been the most common form of reconstruction in women with Poland syndrome.
69
When correction of the infraclavicular territory was necessary, an ipsilateral free gracilis flap was anastomosed to the internal mamary vessel’s
F. When correction of the infraclavicular territory was necessary, an ipsilateral free gracilis flap was anastomosed to the thoracodorsal vessels
70
No need for imaging modality before operation in free flap reconstruction of poland syndrom
F. Because of the incidence of vascular anomalies in the recipient vessels, preoperative angiography should be strongly considered
71
Rohrich described the most utilitarian method for classifying gynecomastia, based on the amount and character of breast h yp ertrophy and degree of ptosis
T Rohrich described the most utilitarian method for classifying gynecomastia, based on the amount and character of breast h yp ertrophy and degree of ptosis
72
The risk of breast cancer increases with gynicomastai patients
The risk of breast cancer in patients with gynecomastia remains equivalent when compared with the normal male population
73
What is saucer-type deformity in gynicomastia?
Overzealous subareolar resection may lead to a saucer-type deformity under the areola
74
Augmentation-mastopexy techniques are associated with high revision rates of up to one in five, although this may be reduced to less than 1 in 10 by staging the procedure.
T
75
what the primary goal of augmentation mastopexy ?
The primary goal of the surgery is to
increase the size of the breast,
76
now BA can be
performed almost exclusively with silicon implant if desired
now BA can be performed almost exclusively with a patient's own tissue i
if desired
77
BA affect the size of
the breast, but also the overall gland shape and position of the NAC.
T
78
The breast mound should reside
completely or largely above the inframammary fold (IMF) regardless the age of the patients.
The breast mound should reside
completely or largely above the inframammary fold (IMF) although
this can vary with age
79
What is the Standard measurements before BA?
Standard
measurements before BA include base width (BW), sternal notch
to nipple distance (SN-N), nipple to inframammary fold (N-IMF),
NAC diameter, and internipple distance
80
2 cm of pinch thickness is considered the minimum necessary for placement of an implant in the subpectoral plane
2 cm of pinch thickness is considered the minimum necessary for placement of an implant in the subglandular or subfacial
81
why the width of sternum is importent?
width of the sternum is
a nuance that can help the surgeon talk to a patient about expected
superomedial fullness and interbreast distance that will likely persist
after augmentation.
82
ultrasound (US) or magnetic resonance imaging (MRI) is better than mammogram in monitering of beast augmented patients
T
83
Patients who seek
BA who have no visible breast skin below the NAC on a frontal view
(grade i ptosis)
Patients who seek
BA who have no visible breast skin below the NAC on a frontal view
(grade III ptosis) ikely need a mastopexy as well to reposition the
NAC on the breast mound
84
normal positins of IMF atthe middle of humerous?
IMF at the middle of the humerus may be considered "high" breasted
85
what factors influence the tissue integration of implants with breast tissue ?
Surface area, pore size, and distribution may
play a role in soft tissue integration with the breast implant surface,
the organization of myofibroblasts and matrix proteins, and potential for accumulation of bacterial biofilms.*-
86
MRI is recommended to visualize a suspicious seroma or mass after breast implant .
A PET-CT scan is recommended to visualize a suspicious seroma or mass.
87
Capsular contracture rates based on plane of implant only
Capsular contracture rates from long-term studies
demonstrate variability based on implant manufacturer.
88
Saline implants has risk of rupture more than silicon
Implant rupture can occur regardless of implant fill material
89
removal of one or both implants and any
ruptured material in the case of silicone rupture with capsulectomy
removal of one or both implants and any
ruptured material in the case of silicone rupture with or without capsulectomy or capsulotomy
90
Inmastopexy the discrepancy between the skin and breast tissue can be reduced
T
91
what the draw back of Periareolar mastopexies?
flatten and reduce breast projection.
Scar widening and eventual widening of the areola can occur
If there is circumferential full thickness violation of the
dermis, decreased nipple sensitivity
92
Vertical mastopexies can be used to address grade 1.2 ptosis
all grades of breast ptosis
93
verical mastopexy can be used with implant placement?
This technique is not
typically complemented with implant placement but can do it with wise pattern technique
94
the percentage of revision rate in periareolar mastopexy approach?
50%
95
The revision rate in one step augmentation mastopexy WAS
revision rates between '
8.6% and 23.2%,
Meta-analyses of reports of single-stage
mastopexy-augmentation have found an overall complication rate of
13% with a reoperation rate of 11
96
There is no consensus of whether augmentation or mastopexy should be
performed in a two-staged plan
T
97
The lymphatic drainage of the breast includes the supraclavicular?
F. Lymphatic pathways parallel the venous drainage and include cutaneous, internal mammary, posterior intercostal, and axillary routes.
98
Preoperative mammography is mandatory for all patients will underwent breast reduction
Preoperative mammography is not necessary for elective breast reduction before the age at which screening mammography is generally recommended
99
The exact position of NAC ?
This mark should be very close to a hypothetical line that
connects laterally to ~2 cm below the midpoint of the upper arm. t should be ~2 cm above the projected IM fold
100
in the inferior pedicle flap some surgeons prefer to elevate the upper flaps first. is it true ?
We found that elevating the inferior pedicle initially works best for us
101
In superomedial pedicle with vertical skin excision we use only supra medial pedicle? True
If the NAC is positioned high in the superior aspect of the keyhole pattern, the surgeon may want to consider using a superior pedicle
102
What is the percentage of hematoma in Breast reduction, and breast implant/
In breast implant 1% in breast reduction 4%
103
The breast bud beneath the nipple areolar
complex should be palpated, and is often tender to the patient with
drugs induced gynecomastia
The breast bud beneath the nipple areolar
complex should be palpated, and is often tender to the patient with
idiopathic gynecomastia
104
In patients with Klinefelter syndrome, their risk of
developing breast cancer is almost 60 times greater than the female
In patients with Klinefelter syndrome, their risk of
developing breast cancer is almost 60 times greater than the general
male population,
105
the main composition of pseudo gynecomastia are glandular tissue
pseudo gynecomastia composed of fat only
106
the percentage of gynecomastia patients whom responded to tamoxifen
83.3% no FDA approved
107
what is the prophylactic indication approach in patient taking biclutumide for prostate cancer ?
Tamoxifen 10 -20 mg or anastrozole or radiotherapy
108
when you can proceed with the surgical option of gynecomastia?
after one year
109
Suction-assisted lipectomy is an excellent option for patients with
minimal to moderate tissue and skin excess. Ifthe breast enlargement
is predominantly adipose T OR F
T
110
IMF should be preserved in liposuction of gynecomastia patients
The surgeon should intentionally disrupt the inframammary fold, because such dermoglandular attachment is feminizing . Instead, the
lower pole may be contoured via liposuction to emphasize the inferior border of the pectoralis major muscle and create more masculine
definition
111
Most
patients in grade II b gynicomastia will exhibit adequate skin retraction, and do not elect further surgery with us liposuction T OR F
T
112
The average diameter of a male nipple is
2.8 cm
113
the best surgical approuch for bodybuilders, the gynecomastia is usually glandular and fibrotic, as these patients have a paucity of body fat.
Direct excision of the enlarged gland via a pullthrough technique is often indicated
114
in morbid obesity patient with gynicomastia with excess skin and adipose tissue, an open approach with skin
excision is always necessary.
F excess skin and adipose tissue, an open approach with skin
excision is often necessary.
115
Compression garments post op should the patients wear it for 1 month post op
F . 3month
116
What is the indication of radiotherapy in breast cancer patients?
Patients with large tumors (>5 cm),
four or more involved lymph nodes,
positive or close margins,
and those with locally advanced breast cancer.
117
Nipple-sparing mastectomy indications?
Oncologic factors suggestive of suitable cases for nipple-sparing mastectomies include tumors >2 cm from the nipple
and no clinical involvement of the skin or nipple
118
Hereditary breast cancer accounts for up to 20% T OR F
T
119
BRCA 1 and
2 gene mutations account for 20% to 40% of the hereditary breast
cancers. T OR F
T
120
What is teh most common type of breast cancer?
The most common types of breast cancer include ductal carcinoma
in situ (DCIS)
121
ductal carcinoma in situ (DCIS) and lobular carcinoma in situ can transform into invasive cancer T OR F
DCIS can transform into invasive cancer.
Lobular carcinoma in situ (LCIS) does not transform into invasive
disease but instead increases one's risk by 7 to 12 times for developing
invasive cancer in either breast
122
regular clinical breast examinations for breast cancer are recommended for average-risk women at any age
no regular clinical breast
examinations for breast cancer are recommended for average-risk
women at any age
123
Using MRI in breast cancer detection can improve over all survival.
Although breast MRIs are generally more sensitive than mammography or
ultrasonography, they have not been found to improve overall survival outcomes or improve locoregional recurrence rates.
124
Is breast conservative therapy show result inferior to radical mastectomy?
BCT is appropriate for early stage
breast cancer and has been shown to provide equivalent overall survival rates compared to total mastectomy
125
smoking considered an absolute contraindications for skin-sparing mastectomy
smoking (relative contraindication
126
Local recurrence rates after
SSM is worse than other forms of mastectomy.2
Local recurrence rates after
SSM are similar to other forms ofmastectomy.2
127
in skin-sparing mastectomy the nipple is preserved T OR F
F the nipple removed also
128
the contralateral mastectomy increase the over all survival in high risk patients?
Rates of contralateral prophylactic mastectomy are increasing without
evidence ofsubstantial improvement of overall survival
129
the percentage of lymodema after axilary lymphnode disection ?
An axillary lymph node
dissection (ALND) has a 16% risk of the development of lymphedema at 5 years
130
Acellular dermal matrix used to cover part of implant. T or F
Acellular dermal matrix used to cover all the implant
131
What are the Risk factors for complications in implant reconstruction
Smoking
■ Obesity (BMI >30)
■ Large breasts
■ Diabetes (Hgb AlC >6.5%
132
stoping smoking abouy 1 month considred enoupg before breast reconstraction
there is some evidence that the rate of complications in former smokers, those who stopped smoking I month or more
before surgery, is similar to the rate of complications in active smokers.
133
well control diabetes decrease the incidence of wound-healing problem in prosthetic breast implant reconstraction
even well-controlled diabetes (average preoperative blood glucose 137 mg/
dL) increases the I-year rate of wound healing problems following
prosthetic but not autologous reconstruction
134
The weight t of the patients does not affect the outcome of the prosthetic breast reconstruction?
F patients with BMI >30 were almost seven times more likely to experience reconstructive failure following prosthetic reconstruction than their nonobese counterparts
135
macromastia is not a contraindication
to implant-based reconstruction,
T
136
the complications rate between immediate and delay breast reconstruction are comparable
delayed prosthetic reconstruction
have argued that this approach results in a lower rate of complications including mastectomy skin flap necrosis, capsular contracture, and need for device removal
137
quality mastectomy is a major determinant ofthe success of
direct-to-implant reconstruction T or F
T
138
Is their are difference in complication rate between single vs staged breast reconstruction?
Basta et al. found a significantly increased risk of skin flap necrosis, need for reoperation,
and reconstructive failure in patients undergoing direct-to-implant
reconstruction. The overall
absolute rate of implant loss was 14.4% for single- and 8.7% for two-stage reconstruction
139
Acellular Dermal Matrix can improve lower pole projection T OR F
T
140
Benefits of ADM?
- ADM can help maintain the device in the optimal position on the chest wall,
- add definition to the inframammary fold and lateral breast border,
- improve lower pole projection
- higher intraoperative fill volume and shorter time to optimal expansion.
- ADM is useful in both the primary prevention and secondary treatment of capsular contracture
- ADM may ameliorate some of the
negative sequelae associated with radiation treatment.
141
the most important parameter for breast implant is projectoin T OR F
Base width
142
Expander capacity is important
Expander capacity is less important as many expander devices
maybe filled well beyond their stated maximum volumes
143
Silicon implant has lower risk of rapture than Normal saline implant T OR F
Rates of rupture and capsular contracture
may be slightly higher in silicone implants than in saline
144
patients with silicone implants are more likely to develop rare neurologic or connective tissue diseases
There is no evidence to support the idea
that patients with silicone implants are more likely to develop rare
neurologic or connective tissue diseases
145
Textured implant decreases lower pole stretch over time T OR F
T
146
all anatomic-shaped implants are textured T or F
T
147
Shaped implants may result in improved upper
pole shape and volume, especially in reconstruction of breasts that are
taller than they are wide T OR F
T
148
In case of falp skin viability is a concern in breast reconstraction with implant if viability or skin
quality is a concern, placement of a device is abslute contraindicated and may be deferred to a later time
F placement of a device is relatively contraindicated and may be deferred to a later time
149
The sternal origin of pectoralis major should never be compromised.
muscle origin along the most inferior
portions of the sternum may be divided further if increased lower
pole projection is needed or desired
150
Radiation of a prosthetic device can lead to increased rates of early
complications such as hematoma
F Radiation of a prosthetic device can lead to increased rates of early
complications such as infection, seroma, and mastectomy flap necrosis
151
Radiation of the permanent implant
was associated with a higher rate of capsular contracture and subsequently worse aesthetic outcomes.
T
152
In Radiation of the tissue expander, increasing the interval of time between completion of radiation and exchange to permanent implant appears to improve outcomes, with intervals ranging from 3 to 8 months.
T
153
despite a higher rate of complications, prosthetic reconstruction can be effectively accomplished in
the previously irradiated breast T OR F
T
154
The uses of ADM in previously irradiated patients is not protective against reconstructive failure
the use of ADM in previously irradiated patients is not
protective against reconstructive failure and may increase the rate
of skin flap and infectious complications, perhaps due to its inability to incorporate into a poorly vascularized, irradiated mastectomy
flap
155
Delay the time from radiation to the definitive breast reconstruction more than 1 year can significantly decrease
Although increasing tl1e time interval between previous irradiation and salvage mastectomy beyond 1 year does not appear to
improve the rate of complications,
156
performing the reconstruction in
a delayed rather than immediate fashion may result in a lower rate of
reconstructive failure. T OR F
T
157
there is no clear evidence that either neoadjuvant or adjuvant chemotherapy increases complication rates in patients undergoing prosthetic reconstruction
T
158
all breast hematomas require return to
the operating room for evacuation,
most hematomas require return to
the operating room for evacuation,
159
implant salvage is possible in case of infection with staph aureus
elevated white blood cell count at admission and methicillin-resistant S. aureus (MRSA) infection as predictors of salvage failure
160
Rates of capsular contracture following implant-based reconstruction at 3 years are estimated at between 10% and 13%
T
161
Clinical exam remains the standard for postoperative flap
monitoring.
T
162
In case of autologous breast reconstruction the need for post mastectomies radiotherapy is absolute contraindications for breast immediately reconstruction
The need for PMRT, though not an absolute contraindication to immediate reconstruction, tends to be the predominant reason to consider delayed reconstruction
163
Hypercoagulable conditions would be a contraindication to performing a free tissue transfer pedicled flap options would be possible in this context
T
164
imaging is absolutely needed in patients planned for autologous reconstruction of the the breast
imaging is not absolutely needed in patients without a surgical history
165
LD muscle harvested with a skin paddle
typically does not provide sufficient volume for breast reconstruction.
T
166
The percentage of the abdominal flap wich are superficially SIEA dominant?
10%
167
THE PERCISE ;OCATION OF SUPERFICAIL INFERIOR EPIGASTRIC ART ?
superficial to the Scarpa fascia and within 5 to IO cm lateral from
the midline
168
Perfusion of flaps based on the SIEA/SIEV is
not reliable across the midline. T OR F
T
169
perforators required for DIEP flap elevation are
located within a 10 cm radius from the umbilicus T OR F
T
170
primary closure without mesh is
often possible with DIEP flap and free ms-TRAM flap harvests.
T
171
TRAM harvests tend to include wide sections of anterior rectus
fascia and may require mesh placement, particularly in cases with
bilateral flaps.
T
172
BLOOD SUPPLY OF Medial thigh flaps?
The medial circumflex femoral artery, a branch of the profunda femoris artery
173
The TUG does not provide as much skin or fat as the VUG T OR F
T
174
vertical upper gracilis (VUG) flap provide a
more reliable skin paddle. T OR F
F TUG FLAP PROVIDE RELIABLE SKIN PADDDLE
175
At the level of the third rib, the IMA generally
lies medial to the IMV. F OR T
F LATERAL
176
At the third and fourth intercostal spaces. The left IMV
bifurcates at a higher level than the right IMV
T(third rib on the left
vs. fourth rib on the right)
177
At the level of the third intercostal space,
the left IMV is on average smaller than the right (2.5 mm vs. 3 mm) T OR F
T
178
Grafting remains a favorable option in patients who have thick skin and subcutaneous tissues
Grafting remains a favorable option in patients who have thin skin and subcutaneous tissues following alloplastic breast reconstruction
179
Centrally based flaps such as the quadrapod flap are subject to the highest degree to preserve the nipple projection
Centrally based flaps such as the quadrapod flap are subject to the highest degree of postoperative retraction
180
Tattooing is generally performed 10 weeks after reconstruction of the nipple
Tattooing is generally performed 6 to 8 weeks after reconstruction of the nipple
181
milk line that extends ventrally along the embryo, from the axilla to the groin roughly medial to the midclavicular line
milk line that extends ventrally along the embryo, from the axilla to the groin roughly lateral to the midclavicular line
182
There are no genetic inheritance in bilateral absence of the breast?
Genetically inherited bilateral absence of the breast has been described
183
It is important to ask about the cancer history in fat graft patients?
Careful consideration of familial breast cancer history is mandatory when employing fat transfer techniques.
184
In tuberous breast there is thickening of penetrating suspensory ligaments in
T
185
How many percentage of tuberous breast patients need expansions ?
In Kolker and Collins' series, 8% of total or 30% of Groleau type III tuberous breast required expansion
186
In inverted T tuberous breast correction The success of these internal rearrangement techniques is contingent on the presence of enough tissue to augment the h ypoplastic lower pole.
T
187
In tuberous breast we sho not remoce any prenchymal tissue T or F
F. remove excess gland from the deepest aspect of the subareolar gland to keep the implant size similar and prevent future herniation.
188
In dual plane of tuberous breast prepectoral undermining beyond the upper edge of NAC
prepectoral undermining to the upper edge of the NAC,
189
In familiar predisposition of poland syndrom ocuures mor common in male T or F
F. Familial cases have equal incidence in sexes and laterality.
190
The percentage of poland syndrom in breast hypopalsia
Poland syndrome is involved in 14% of breast aplasia.
191
Why there is prominant posterior fold in axila of poland syndrom patient?
compensatory hypertrophy of the teres major that simulated the normal contraction of the latissimus dorsi muscle.
192
10% of syndactyly is a result of Poland syndrome. Tor F
T
193
The percentage of the patients who developed aplsia of the rips ?
Aplasia of the ribs and cartilage involving rib segments two to five often leads to severe chest depression in 11% to 25% of patients.
194
Eight percent of patients may have lung herniation.in poland syndrom
T
195
Dextrocardia is present in 5.6% of patients, which rises to 9.6% when the deformity was on the left side.
T
196
In poland Lipofilling can also be used to camouflage chest abnormalities and may obviate the need for custom silicone devices
T
197
there have been no descriptions of use of ADM to secure the implant and to reduce the incidence of capsular contracture in Poland syndrome.
T
198
Because of the incidence of vascular anomalies in the recipient vessels, preoperative angiography should be strongly considered in poland syndrom
T
199
Because of the incidence of vascular anomalies in the recipient vessels, preoperative angiography should be strongly considered
T
200
The defense between ANTERIOR THORACIC HYPOPLASIA and poland syndrom
a normal pectoralis major and sternum position
201
ANTERIOR THORACIC HYPOPLASIA All the patients treated with subglandular implant. T or F
F. All patients in his series were treated with a partial submuscular anatomical implant.
202
demonstrated that recurrence of breast growth is sevenfold higher following a reduction mammaplasty compared with mastectomy
T
203
With careful preservation of the subareolar gland, most studies have indicated the rates of breast feeding in patients with breast hypertrophy with and without reduction mammaplasty to be equivalent ( ~60%
T
204
Giant fibroadenoma refers to when the tumor is larger than 5 cm in diameter and/or weighs more than 100 g. F. or T
F. Giant fibroadenoma refers to when the tumor is larger than 5 cm in diameter and/or weighs more than 500 g
205
Pathologically, fibroadenoma is difficult to distinguish from phyllodes tumor
T
206
All cases of polythelia cases are generally sporadic;
F. cases of familial inheritance patterns have been reported. They may be associated with nephrourologic abnormalities and therefore a urinalysis and renal ultrasound is necessary
207
breast cancer can occur with the accessory tissue at an equal rate to the natural breast.
T
208
The incidance of polythelia is less common than poly mastia ?
F poly thelia 5.6% polymastia. 1-2%
209
Although most cases of gynecomastia during adolescents are idiopathic, the most common cause in those >40 years old is most often drug induced.
T
210
Webster described a classification of gynecomastia. depend on the shape of the breast
Webster described a classification based on tissue type
211
The risk of breast cancer in patients with gynecomastia is more when compared with the normal male population
The risk of breast cancer in patients with gynecomastia remains equivalent when compared with the normal male population
212
he incidence of breast cancer is 60 times higher in patients with gynecomastia associated with klienfelter syndrom
T
