Breast Flashcards
LCIS with discordant imaging; next step
Excisional bx + tamoxifen
BI-RADS 0 next step
Diagnostic mammo
Serious complication of nipple spring mastectomy
Nipple necrosis
Risk of carcinoma with atypical ductal hyperplasia
15-30%
Breastfeeding asymptomatic breast cyst, normal tissue FNA with duct debris; dx and tx
Galactocele, continue breast feeding
Highly suggestive of malignancy; BI-RADS and tx
5, bx required
Breast BX with small ovoid cells with little cytoplasm in infiltrating single file line; dx and tx
Infiltrating lobular carcinoma, lumpectomy, SNLB, rads +/- chemo
Breast bx atypical ductal hyperplasia next step
Excisional bx
First step management of lymphedema
Compression garments
Tumor emboli in dermal lymphatics
Inflammatory breast cancer
Contraindications for BCT requiring radiation
Pregnancy, diffuse calcifications, widespread lesions, margins difficult or unable to be achieved
Breastfeeding, painful, swollen, fevers; dx and tx
Mastitis, abx and continue breastfeeding
DCIS tx including margin
Excision with 2mm margin followed by radiation and endocrine therapy
Diagnostic breast imaging during pregnancy
Mammo and US with needle bx
Inflammatory breast cancer treatment
Neoadjuvant chemo, MRM, radiation and endocrine therapy
Multiple breast I&Ds with bx showing fibroepithelial lesion; dx
Phyllodes
Nipple discharge concerning for malignancy
Unilateral, spontaneous, bloody
Painful, tender, subcutaneous cord lateral breast; dx and tx
Mondor disease (thrombophlebitis of breast), NSAIDs
Bloody nipple discharge unable to identify duct, tx
Central duct excision
Most common cause breast fat necrosis
Trauma
Most common cause of breast Ca under 30yo; dx and US description
Fibroadenoma, we’ll circumscribed solid mass may have calcifications
Association between breast cancer and gynecomastia
Klinefelter’s Syndrome
Benign condition which lactiferous ducts become occluded, can mimic cancer
Duct ectasia
ER+/HER2- Male breast cancer s/p MRM with negative LN, next step
Tamoxifen
Failure to map hot or blue nodes on SLNB, next step
ALND
Unilateral, spontaneous, bloody discharge, BIRADS 1, core needle with atypical cells; next step
Terminal duct resection
Best reconstruction option after mastectomy and irradiation
Deep Inferior Epigastric Perforator (DEIP) flap
Biggest risk factor for complications following TRAM
Obesity
Lymph nodes below pec minor
Level II
Indication for radiation s/p mastectomy for breast cancer
T3-4 or N2-3; greater than 5cm, fixed nodes, 4+ nodes, extracapsular nodes, chest wall involved, IBC
Invasive breast cancer benefits of postop radiation
Decreases local recurrence
Protein debris in milk duct
Galactocele
2cm invasive ductal Ca ER/PR+ and HER2- next step
BCT - Lumpectomy, SLNB, radiation
Absolute contraindications BCS
Diffuse malignant appearing microcalcifications
Positive margins
Wide spread disease
Scaly, ulcerated crust of areola; dx and tx
Pagets of the nipple, mastectomy (include wide excision of nipple areola complex) and SLNB
Changes to prior mastectomy scar, next step
Biopsy
Breast reconstruction associated with lowest risk of complication when needing post-mastectomy radiotherapy
Delayed autologous reconstruction
Breast cyst resolved after aspirating light gray fluid; dx and next step
Simple breast cyst, US in 4-6weeks
Z0011 Inclusion Criteria
Clinically negative nodes
T1/T2
2/3 or less nodes
No contraindication to radiation
Latissimus dorsi flap blood supply
Thoracosorsal artery/vein
What causes gynecomastia
Excess estrogen to testosterone ratio
