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SURGERY > Breast > Flashcards

Breast Flashcards

1
Q

Suspensory ligaments/bands of connective tissue that extend from the skin to the deep fascia and provide structural support to the breast

A

Suspensory ligament of Cooper

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2
Q

Anatomical part of the Breast tissue that extends to the Axilla

A

Tail of Spence

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3
Q

Inferior border of the Breast

A

Inframammary fold (6th or 7th rib)

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4
Q

Superior border of the Breast

A

2nd or 3rd rib

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5
Q

Medial border of the breast

A

Lateral border of the sternum

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6
Q

Lateral border of the breast

A

Anterior axillary line

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7
Q

Percentage of breast lymph drainage that drains to the axillary nodes

A

75%

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8
Q

Level of Breast lymph nodes found anterior or posterior to the pectoralis minor muscle

A

Level II

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9
Q

Level of breast lymph nodes above/medial to the upper border of the pectoralis minor muscle

A

Level III

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10
Q

Level of breast lymph nodes lateral or below the lower border of the pectoralis minor muscle

A

Level II

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11
Q

Axillary lymph node groups found in Level I

A

Scapular
External Mammary
Axillary vein

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12
Q

Axillary Lymph node groups found in Level II

A

Central
Interpectoral (Rotter nodes)

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13
Q

Axillary Lymph node groups found in Level III

A

Subclavicular

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14
Q

The first lymph node/s that drain breast cancer

A

Sentinel Lymph nodes

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15
Q

Muscle innervated by the long thoracic nerve

A

Serratus Anterior

(winging of the scapula)

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16
Q

Muscle innervated by the Thoracodorsal nerve

A

Latissimus dorsi

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17
Q

Absence of breast tissue, nipple, and areola

A

Amastia

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18
Q

Absence of breast tissue but nipple and areola remains

A

Amazia

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19
Q

Failure of the underlying mesenchymal tissue to proliferate and project the nipple papilla outward

A

Inverted nipple

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20
Q

Loss of the medial edge of the breast with resulting absence of cleavage

A

Symmastia

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21
Q

Enlargement of the male breast resulting from proliferation of glandular tissure caused by increased ratio of estrogen to androgenn

A

Gynecomastia

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22
Q

3 stages in a male’s life prone to Gynecomastia due to excess circulating estrogens relative to circulating testosteron

A

Neonatal
Adolescence
Senescence

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23
Q

Pathophysiology of Gynecomastia

A

Estrogen excess
Androgen deficiency
Estrogenic drugs/steroids
Systemic diseases

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24
Q

Imaging for Gynecomastia

A

Mammogram or Ultrasonography

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25
Q

Surgical techniques for Gynecomastia

A

Local excision
Liposuction
Subcutaneous Mastectomy

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26
Q

Pathogen seen in breast abscesses that are localized and deep

A

S. aureus

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27
Q

Pathogen seen in breast abscesses that are diffuse and superficial

A

Streptococcus pyogenes

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28
Q

Most common pathogen for Mastitis

A

Staph aureus

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29
Q

Variant of thrombophlebitis that
involves the superficial veins of the anterior chest wall and breast

A

Mondor Disease (Superficial Thrombophlebitis)

30
Q

Mondor disease is a usual complication after what procedure

A

Breast augmentation

31
Q

Benign breast neoplasm that mimics invasive ductal carcinoma on mammo: dense solid rodlike calcifications

A

Duct Ectasia

32
Q

Benign breast neoplasm that mimics invasive ductal carcinoma on mammo: dense solid rodlike calcifications

A

Duct Ectasia

33
Q

Benign breast tumor of fibrous and epithelial elements, most common solid mass found in women of all ages

A

Fibroadenoma

34
Q

Management of Fibroadenoma for patients <25-30 years with a typical imaging appearance

A

Close clinical followup

35
Q

Management of Fibroadenoma for patients >30 years without prior mammogram

A

Needle aspiration, Mammography: assess
borders of lesion

36
Q

Proliferation of glandular and stromal elements in the breast resulting in enlargement and distortion of lobe units

A

Sclerosing Adenosis

37
Q

Finding of Sclerosing Adenosis on Mammogram (mimics breast carcinoma)

A

Diffuse microcalcifications

38
Q

Management of finding of Sclerosing Adenosis (Diffuse microcalcifications)

A

Excisional biopsy to exclude diagnosis of carcinoma

39
Q

Characterized by central necrosis and varying degrees of epithelial proliferation, apocrine metaplasia and papilloma formation

A

Radial and Complex Sclerosing Lesions

40
Q

Breast condition involving an Increased number of cells relative to that normally observed above base membrane

A

Ductal Epithelial Hyperplasia

41
Q

Also called “Swiss cheese disease” it is a focal palpable mass that may be a marker for families at risk of breast cancer

A

Juvenile Papillomatosis

42
Q

Architectural classification of DCIS that shows Large cells, nuclear pleomorphism, mitotic activity, often associated with microinvasion

A

Comedo

43
Q

Architectural classification of DCIS that shows small cells, small hypochromatic nuclei, back-to-back glands

A

Cribriform

44
Q

Architectural classification of DCIS that shows lntraluminal projection of cells, club shaped, that lack fibrovascular cores

A

Micropapillary

45
Q

Architectural classification of DCIS that shows lntraluminal projection of cells, fibrovascular cores

A

Papillary

46
Q

Multiple separate foci of disease occur within the same quadrant of the breast

A

Multifocal

47
Q

The foci of disease present in different quadrants of the breast, arising
simultaneously in different, disconnected duct systems

A

Multicentric

48
Q

Eczematous, scaly skin at the nipple and areolar complex associated with an underlying in situ or invasive breast cancer

A

Paget disease of the breast

49
Q

Most common type of non-invasive breast neoplasm without invasion of the basement membrane

A

Ductal Carcinoma in Situ

50
Q

Model that described a gradual histological, nonobligatory series of abnormal stages leading to cancer in the terminal duct-lobular unit (hyperplasia > atypia > in situ lesions > invasive cancer)

A

Wellings-Jensen Model

51
Q

DCIS vs LCIS

Age in years

A

DCIS: older (54-58)

LCIS: younger (44-47)

52
Q

DCIS vs LCIS

Presentation

A

DCIS: Incidental on mammo, nipple discharge, paget disease, palpable mass

LCIS: incidental on biopsy, usually no clinical signs

53
Q

DCIS vs LCIS

Cell size

A

DCIS: Medium/Large

LCIS: Small

54
Q

DCIS vs LCIS

Pattern

A

DCIS: Comedo, Cribriform, Micropapillary, Solid

LCIS: Solid

55
Q

DCIS vs LCIS

Calcification

A

DCIS: Usually present (seen on mammo)

LCIS: Usually absent

56
Q

DCIS vs LCIS

Relation to Breast cancer

A

DCIS: precursor lesion

LCIS: risk factor

57
Q

DCIS vs LCIS

Risk of subsequent invasive cancer

A

DCIS: Higher

LCIS: Lower

58
Q

DCIS vs LCIS

Location of subsequent cancers

A

DCIS: Ipsilateral

LCIS: Bilateral

59
Q

Primary diagnostic tool for breast cancer detection and diagnosis

A

Mammogram

60
Q

Mammographic hallmark in Breast cancer

A

Calcifications:
Pleomorphic, with linear, branching, irregular or granular forms

61
Q

Diagnostic imaging tool used for detecting residual disease, occult breast cancers, or multicentric lesions

A

MRI

62
Q

Indications for Breast conservation therapy (Segmental mastec, lumpectomy, quadrantectomy, wide local excision)

A

Low grade DCIS, no necrosis, non-comedo, multifocal

63
Q

Indications for Total Mastectomy

A

> Multicentric disease
Diffuse microcalcifications on mammo
Unable to obtain histologically negative margins after multiple excision
Large tumor size with predictably bad cosmetic outcome
Patient preference

64
Q

Indications for Sentinel LN Biopsy

A

> Mastectomy with diffuse disease
Presence of microinvasion
Extensive high grade disease or necrosis in core biopsy
Imaging studies suggestive of invasion

65
Q

Hormonal therapy for patients with ER receptor (+) DCIS

A

Tamoxifen

66
Q

LCIS Pathophysiology

A

Filling, distention, and distortion of over half the acini of a lobular unit by a homogenous population of characteristic cells

67
Q

Biomolecular profile usually found in LCIS

A

HR (+)
HER2/neu (-)

68
Q

Most common indication for a breast biopsy that leads to a diagnosis of LCIS:

A

Nonpalpable mammographic abnormality or microcalcification

69
Q

Characteristic of calcifications (if any) seen in LCIS

A

Neighborhood calcification (occurs outside of the focus of LCIS)

70
Q

Chemoprevention regimen for LCIS

A

Tamoxifen 20mg PO for 5 years.

Reduces risk of invasive cancer by 55%

71
Q

Side effects of Chronic Tamoxifen use

A

> Hot flashes
Endometrial cancer
Venous thromboembolism

72
Q
A

SURGERY (13 decks)

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