Breast Flashcards
1
Q
When to 2ww
A
- unexplained lump >30
- Unilateral nipple changes >50
- Skin changes
Non urgent referral - Unexplained lump in <30
2
Q
Whats in triple assessment
A
- Clinical assessment
- Imaging = USS, mammography
- Histology = fine needle, core biopsy
3
Q
Fibroadenoma
A
- Benign tumours of stromal/epithelial
- painless, smooth, round
- Mobile
4
Q
Fibrocystic breast changes
A
- Benign
- stroma, ducts and lobules respond to hormons = fibrous and cystic
- lumpy, tender, size change
5
Q
Mx fibrocystic
A
- good bra
- NSAIDs
- Heat
- Hormonal tx
6
Q
Breast cysts
A
- Benign individual fluid filled lumps
- Smooth
- Well defined
- Mobile
- Can be fluctuant
- assess to exclude cancer
7
Q
Fat necrosis
A
- benign lump
- localised degeneration and scarring of fat tissue #- localised trauma, radiotherapy or surgery
- Painless, firm, irregular, fixed
8
Q
Lipoma
A
- Benign tumour of adipose
- Soft, painless, mobile, no skin changes
9
Q
Non cyclical breast pain causes
A
- Medications = HRT
- infection
- Pregnancy
- Cancer
10
Q
presentaiton mammary duct ectasia
A
- discharge
- tenderness
- retraction or invesrion
- breast lump
11
Q
Mx MDE
A
- triple assessment
- Mammogram = microcalcifications
12
Q
intraductal papilloma
A
- warty lesion in duct
- nipple discharge, pain, lump
- triple assessment
- mx = surgery
13
Q
mx mastitis
A
- continue breastfeeding
- flucloxacillin
14
Q
Mx breast abscess
A
- non lactational = co amoc, or macrolides plus met
- refer to on call surgery
- abx
- USS
- drainage
- culture
15
Q
pagets
A
- eczematous change due to underlying malignancy
- suspect if eczema not resolved in 2w
- surgery
16
Q
DCIS
A
- pre cancerous or cancerous epithelial cells of ducts
- localised
- mammogram screening pick up
- full excision
17
Q
LCIS
A
- pre cancerous
- asymptomatic and undetectable on mammogram
- breast biopsy
- mx close monitoring
18
Q
invasive ductal carcinoma
A
- originate in cells from breast ducts
- seen on mammogram
19
Q
invasive lobular carcinoma
A
- cells from rbeast lobules
20
Q
inflammatory breast cancer
A
- 1-3%
- similar px to abscess/mastitis but no response to abx
21
Q
breast screening age?
A
- mammogram 3 yearly ages 50-70 (47-73)
22
Q
who count as high risk
A
- 1st degree relative with breast cancer under 40
- 1st deree male relative
- 1st degree with bilateral <50
- 2 1st degree
= annual mammogram
23
Q
chemoprevention for high risk
A
- tamoxifen if pre menopausal
- anastrozole if post
24
Q
3 receptors tested for
A
- oestrogen receptors
- progesterone receptors
- human epidermal growth factor
triple negaive = poor prognosis
25
features of locally advanced cancer
- ulceration
- peau d'orange
- inflammatory breast cancer
- fixed to chest wall
- fixed, matted axillary ln
26
primary tx
-tx intended to cure, or to allow easier or lesser surgery
27
adjuvant tx
- any treatment given following primary treatment to prevent recurrence or mets
28
radiotherapy
- used in breast conserving surgery to reduce recurrence
29
3 scenarios for chemo
- neoadjuvant = shrink pre surgery
- adjuvant = after surgery to reduce recurrence
- tx of mets
30
meds to oestroge positive
- tamoxifen for pre menopause
- aromatase inhibitors for post = letrozole
31
tamoxifen is
- selective oestrogen receptor modulator
- blocks ER in breast
- Stimulates Er in bones and uterus
32
amromatase inhibitors work by
- aromatase converts androgens to oestrogen
- inhibs work by blocking creating of oestrogen in fat tissue
33
trastuzumab is
- monoclonal antibody that targets HER2
34
surveillance mammograms every
- yearly for 5 years
35
mastectomy if
- multifocal tumour
- central tumour
- large lesion in small breast
- DCIS >4cm
36
wide local excision if
- solitary lesion
- peripheral tumour
- small lesion large breast
- DCIS <4cm
37
adverse effects Tamoxifen
- mesntrual disturbance
- hot flushes
- VTE
- endometrial cancer
38
anastrozole adverse effects
- osteoporosis (DEXA before intiating)
- hot flushes
- arthralgia
- insomnia
39
