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General Surgery > Breast > Flashcards

Breast Flashcards

1
Q

Breasts are ectoderm in origin, T/F?

A

True.
They’re modified sweat glands

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2
Q

The size of both breasts MUST be the same, T/F?

A

False.
Like all bilateral structures, slight inequality in the size of the breast is normal

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3
Q

The acini of the glands are lined by what type of epithelium?

A

Cuboidal

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4
Q

The main blood supply to the breast is ____

A

The four perforating branches of the Internal Mammary artery (of which the 2nd intercostal branch is the largest)

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5
Q

Mention the artery supply to the breast

A
  1. Perforating branches of the Internal mammary artery
  2. Branches of the Auxillary artery
    • Pectoral branch of Thoraco-acromial artery
    • Lateral thoracic artery
    • Subscapular artery (largest branch of axillary artery)
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6
Q

The venous drainage of the breast can be considered to consist of 3 systems, which are

A
  1. Medial network (that consists of the perforating beaches of the internal mammary vein)
  2. Lateral network (that drains through many tributaries into the axillary vein)
  3. Posterior system (drains through the intercostal veins to join the plexus of vertebral veins & the tributaries of the azygos system)
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7
Q

The lymphatic drainage of the breast is considered to consist of 4 systems, which include

A
  1. Internal mammary chain of lymph nodes
  2. Axillary group of lymph nodes
  3. The Opposite breast & axilla
  4. To the liver via the rectus abdominis muscle
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8
Q

Over 90% of the mammary lymph drains into _____ system of nodes?

A

Axillary group of nodes

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9
Q

Malignant cells can metastasize to lymph nodes not draining the corresponding great quadrant, T/F?

A

True.

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10
Q

Retrograde tumor emboli are the rule where a forward system of the lymphatic is blocked, T/F?

A

True

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11
Q

Which of the cells are believed to effect the emptying of the lactiferous sinuses during suckling?

A

Contractile smooth muscle fibers (which are inserted directly into the skin of the areola & nipple)

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12
Q

The bulk of the areola and nipple is made of _____

A

Contractile smooth muscle fibers.

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13
Q

The structural unit of the breast is the ___

A

Acinus, groups of which form the lobule.

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14
Q

_____ separates the lobules of the breast and gives support

A

Suspensory ligament of Cooper.
(It’s a fibrous connection b/w the two layers of superficial fascia)

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15
Q

The breast overlies certain structures in the chest wall, which include:

(Hint: 4)

A

2nd to 6th ribs, pectoralis major, serratus anterior, and the upper part of the rectus sheath

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16
Q

The most important factor in the maintenance of the lactation cycle is _____

A

Infant suckling

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17
Q

List the cells that secrete Growth factors that are needed for the organization & co-ordination of normal and malignant breast cell proliferation

(Hint:6)

A

Stromal cells of rhe breast
Platelet
Endothelial cells
Epithelial cells
Fibroblasts
Inflammatory cells

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18
Q

Estrogen & progesterone stimulate the stromal cells of the breast and act to influence proliferation through ____ growth factor family?

A

Epidermal growth factor family

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19
Q

The epithelial cells cannot proliferate in the absence of the stromal cells and vice versa, T/F?

And why?

A

True.

Because both need growth factors from each other to proliferate

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20
Q

The involution of the great in elderly women (>55yrs) can be attributed to low levels of estrogen and growth factors, T/F?

A

True.

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21
Q

The male breast consists of ______ & _____

A

Small ducts embedded in fat.

N/B: no alveoli

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22
Q

The complete absence of the breast is called _____

A

Amazia

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23
Q

The presence of multiple breasts is called _____

A

Polymazia

24
Q

The presence of an accessory nipple is called ______

A

Polythelia

25
Q

An accessory breast may simulate or be confused for a ____

A

Lipoma

26
Q

An extra nipple may simulate or be confused with a _____

A

Melanoma

27
Q

A pedunculated areola may simulate or be confused with a _____

A

Plexiform neurofibroma

28
Q

Dilatation of the lactiferous ducts is called

A

Duct ectasia

29
Q

Glandular hyperplasia is termed _____

A

Adenosis

30
Q

Ductal epithelial hyperplasia is termed _____

A

Epitheliosis

31
Q

Stromal proliferation is termed ______

A

Fibrosis

32
Q

Lipid material released into the surrounding ducts and acini can cause an inflammatory reaction, T/F?

A

True.

As seen in the rupture of inspissated material from the lactiferous ducts in ductal ectasia

33
Q

In lactational mastitis, the common causative organism is _____

A

Staphylococcus aureus

34
Q

The treatment of bacterial mastitis is by _______ antibiotics?

A

Cloxacillin or Flucloxacillin

35
Q

List the 6 WHO International typing of Breast tumors

A
  1. Epithelial tumors
  2. Mixed Connective Tissue and Epithelial Tumors
  3. Miscellaneous tumors
  4. Unclassified
  5. Mammary dysplasia
  6. Tumor-like lesions
36
Q

The highest incidence of Benign mammary dysplasia (Fibroadenosis) is in women b/w what ages?

A

30 and 40

37
Q

_____ will help differentiate the nipple discharge of carcinoma from ductal ectasia

A

Galactography

38
Q

Probably the commonest cause of nipple discharge is ____

A

Ductal ectasia

39
Q

Traumatic fat necrosis of the breast is confined to fat women, T/F?

A

False.

40
Q

The features of traumatic fat necrosis of the breast are indistinguishable from those of early carcinoma of the breast, T/F?

A

True

41
Q

The majority of cysts are in the lower outer quadrant, T/F?

A

False.

Upper outer quadrant

42
Q

A milk-containing cyst that develops during lactation is called _______

A

Galactocele

43
Q

______ constitutes about 75% of all benign breast tumors

A

Fibroadenoma

44
Q

Does Fibroadenoma develop during the reproductive period, T/F?

A

True

45
Q

Which clinical type of Fibroadenoma is much more common?

A

Pericanalicular (or hard) fibro adenoma

46
Q

Possible treatments for Fibroadenoma

A
  1. Excision biopsy
  2. Conservative regimen ( mammography & FNAC done first. Can be used for small tumors)
47
Q

Treatment for Cystosarcoma phyllodes
- Benign
- borderline
- malignant

A

For Benign - Wide local excision
For Borderline & Malignant - Total mastectomy

48
Q

A Duct papilloma may become malignant if it has a _______ core

A

A neuromuscular core

49
Q

The main symptom of Duct Papilloma is

A

Recurrent bleeding from a solitary duct in the nipple

50
Q

Treatment for Duct Papilloma

A

Excision of the entire lobule drained by the affected duct

51
Q

The estrogen & progesterone receptor status of a tumor can be determined using a _______

A

Aspiration cytology specimen

52
Q

The three (3) broad investigations that are usually requested are

A
  1. Biopsy (FNAC, Trucut excision, )
  2. Imaging (mammography, CT, X-ray, liver us)
  3. Liver function tests

Check the text for the more details

53
Q

The usefulness of staging of breast cancer

(Hint: 2)

A

Planning treatment and determining prognosis

54
Q

The two(2) classifications of the staging of breast cancer are

A
  1. TNM classification
  2. Manchester or International classification
55
Q

The four hormones (growth tetrad) the normal breast depends on for its full growth & development?

A

Estrogen, progesterone, prolactin, growth hormone

56
Q

Stage breast cancer.

A

Confirm from the text

57
Q

The main indication of breast conservation is ________ or _________

A

Screen-detected (I.e., impalpable) tumor or tumor <2cm without detectable axillary nodes

Summary: TIS, T0, T1a, N0, M0

General Surgery (2 decks)

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