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Core radiotherapy practice > Breast > Flashcards

Breast Flashcards

1
Q

Why is the breast an accessory organ of and what is its involvment?

A

Female reproductive system and it is responsible for lactation (supplying milk to a baby). Not directly involved in reproduction hence accessory name.

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2
Q

Name the 4 surface anatomy features of the breast

A

Areola
Nipple
Body
Axillary tail

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3
Q

Name the 4 quadrants of the breast and state which one has the worst prognosis for breast cancer

A

Upper medial,
Upper lateral, - worst prognosis due to being the axillary tail and this is close to most nodal involvement
Lower medial,
Lower lateral

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4
Q

What is the anatomical name for the breast

A

Mammary gland

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5
Q

What is the milk line?

A

Also known as the mammary ridge, extension of tissue formed during embryonic development that is where the mammary glands form. In humans atrophy occurs of the remaining ridges to just leave two mammary glands being formed (two breasts). Men have nipples because milk lines are formed pre sexual differentiation.

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6
Q

What is the name of the muscle that sits below the breast?

A

Pectoralis major

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7
Q

What hormones are responsible for lactation?

A

Prolactin & oxytocin

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8
Q

What is the name of the 3 major arteries that supply the breast?

A
  1. Thoracic division of the axillary artery
  2. Intercostal arteries
  3. Internal mammillary arteries
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9
Q

What is the name of the venous drainage system from the breast

A

Circulus Venosus

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10
Q

What are the 3 types of tissue that make up the breast?

A

Glandular tissue
Connective/fibrous tissue
Adipose tissue

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11
Q

What is the Coopers ligament?

A

Fibrous tissue found in the breast that separates the lobes and maintains its shape

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12
Q

Describe the pathway of milk from production to the nipple

A

mammary alveoli in the lobules –> secondary tubules –> mammary duct–> lactiferous duct –> lactiferous sinus –> nipple

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13
Q

What ribs do the breast tissue vertically cover

A

2nd - 6th

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14
Q

What structures of the body does the breast extend across

A

Lateral border of sternum to the midaxillary line

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15
Q

what are the two main nodal sites for lymph drainage from the breastS?

A
  1. Axillary nodes
  2. Internal mamillary nodes
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16
Q

Give 5 risk factors of breast cancer

A
  1. Late menopause
  2. Oral contraception
  3. BRCA gene mutations
    4.HRT
    5.Obesity
17
Q

Where do breast cancers most commonly originate?

A

Glandular tissue -
Ductal or lobular carcinoma

18
Q

Give 5 signs/symptoms of breast cancer:

A
  1. Painless lump in breast
  2. lump or swelling in armpit
  3. an eczema like rash on the nipple
  4. inverted nipple
  5. dimpling or thickening of skin/tissue of breast
19
Q

When a breast lump is identified why do patients often go for an ultrasound?

A

To identify whether the lump is fluid filled (cyst) or mass filled (tumour)

20
Q

List 4 type of surgical procedures involved in breast cancer

A
  1. lumpectomy, wide local excision
  2. mastectomy
  3. sentinel node biopsy
  4. axillary node dissection
21
Q

What is tamoxifen

A

Main hormonal therapy used in breast cancer patients following primary to treatment to prevent recurrence.

22
Q

Give two examples of hormone therapy drugs used for breast cancer and their mode of action.

A

Tamoxifen - block oestrogen receptors preventing proliferation of cancer cells

Aromatase inhibitors - reduce oestrogen production

23
Q

What does HER2 stand for and how is it linked to breast cancer?

A

Human epidermal growth factor receptor 2

It is elevated levels in 20-30% of cancers and makes a suitable target in cancer treatment.

24
Q

What is triple negative breast cancer

A

Breast cancer cells do not have the following receptors:

  1. oestrogen
  2. progesterone
  3. HER2

This makes them unsuitable for hormone therapy

25
Q

What is a suitable targeted therapy for a patient who has BRCA mutation +ve cancer?

A

PARP inhibitors - inhibit cell repair of damaged DNA

26
Q

What nodal systems are involved in breast cancer?

A

Axillary nodes - armpit
Sentinel nodes - type of axillary
Supraclavicular - neck above clavicle
Internal mammary nodes - near sternum

27
Q

Give 5 factors that indicate poor prognosis of breast cancer

A
  1. metastatic spread
  2. lymph node involvement
  3. triple negative cancer
  4. high histological grade (poorly differentiated)
  5. Inflammatory histological type
28
Q

What is SGRT

A

Surface guided radiotherapy
Uses 3D cameras to track movement of patient and beam on only when patient in correct position. No tattoos needed.

29
Q

When is radiotherapy most commonly used in breast cancer?

A

Adjuvantly after primary conservative surgery

30
Q

What is the precription for radical radiotherapy (normal and fast course)

A

40Gy in 15#

26 Gy in 5#

Core radiotherapy practice (15 decks)

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