Breast

Question 1

Chemo used for each instance of breast cancer

Answer 1

FEC-D- node +
FEC- node -

Question 2

Snowstorm sign on USS

Answer 2

Implant rupture

Question 3

Most common breast cancer

Answer 3

Invasive ductal carcinoma

Question 4

Indurated area next to nipple, recurrent infections

Answer 4

Periductal mastitis

Question 5

Tx of mastitis

Answer 5

Removal of milk for 12-24 hours
Then flucloxacillin

Question 6

Tx of ductal exctasia

Answer 6

Reassurance

Question 7

SE of aromatase inhibitors

Answer 7

OP fractures

Question 8

Mx of presented with red and thick nipple and areola

Answer 8

Urgent referral

Question 9

Medical treatment of BC

Answer 9

Peri- ER+- tamoxifen
Post- ER +- aromatase

Question 10

Most common cause of blood stained discharge

Answer 10

Intraductal papilloma

Question 11

Herceptin is also called

Answer 11

Trastuzumab

Question 12

Ix of breast cancer after lump confirmed

Answer 12

Axillary ultrasound- if suspicious
Sentinel node biopsy

Question 13

Breast cancer marker

Answer 13

Ca 15 3

Question 14

Non tender highly mobile lump 30s

Answer 14

Fibroadenoma

Question 15

Lumpy breast, can be painful, with menstruation

Answer 15

Fibroadenosis
aka fibrocystic disease

Question 16

Typical firm and round but may develop into a hard, irregular breast lump

Answer 16

Fat necrosis

Question 17

Ix of Fat necrosis

Answer 17

Imaging and biopsy

Question 18

When to remove fibroadenoma

Answer 18

> 3cm

Question 19

Enlarging mass, >50 yrs, pre existing fibroadenomas

Answer 19

Phyllodes tumour

Question 20

Screening programme

Answer 20

47- 73 every 3 years
Mammography

Question 21

When to radiotherapy patient

Answer 21

If had wide local excision

Mastectomy and T3/4

Question 22

When to do mastectomy or WLE

Answer 22

Mastectomy
Multifocal
Large lesion in small breast
DCIS >4cm
Central tumour

WLE
Solitary
Peripheral
Small in large
DCIS <4cm

Question 23

When to operate on axillary nodes

Answer 23

Clinical lymphadenopathy- clearance

No clinical- USS and SLNB- then decide whether to clear

Question 24

Proplems with lymph node clearance

Answer 24

Arm lymphedema
Functional arm impairment

Question 25

SE of tamoxifen

Answer 25

Amenorrhea, endometrial cancer, PV bleed, VTE

Question 26

When to refer on cancer pathway

Answer 26

Refer women aged >30 with an unexplained breast lump using a suspected cancer pathway referral

aged 50 and over with any of the following symptoms in one nipple only: discharge, retraction or other changes of concern

Question 27

Which cancer can show micro calcification on X ray

Answer 27

DCIS