Breast Flashcards
Why is the breast an accessory organ of and what is its involvment?
Female reproductive system and it is responsible for lactation (supplying milk to a baby). Not directly involved in reproduction hence accessory name.
Name the 4 surface anatomy features of the breast
Areola
Nipple
Body
Axillary tail
Name the 4 quadrants of the breast and state which one has the worst prognosis for breast cancer
Upper medial,
Upper lateral, - worst prognosis due to being the axillary tail and this is close to most nodal involvement
Lower medial,
Lower lateral
What is the anatomical name for the breast
Mammary gland
What is the milk line?
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.
What is the name of the muscle that sits below the breast?
Pectoralis major
What hormones are responsible for lactation?
Prolactin & oxytocin
What is the name of the 3 major arteries that supply the breast?
- Thoracic division of the axillary artery
- Intercostal arteries
- Internal mammillary arteries
What is the name of the venous drainage system from the breast
Circulus Venosus
What are the 3 types of tissue that make up the breast?
Glandular tissue
Connective/fibrous tissue
Adipose tissue
What is the Coopers ligament?
Fibrous tissue found in the breast that separates the lobes and maintains its shape
Describe the pathway of milk from production to the nipple
mammary alveoli in the lobules –> secondary tubules –> mammary duct–> lactiferous duct –> lactiferous sinus –> nipple
What ribs do the breast tissue vertically cover
2nd - 6th
What structures of the body does the breast extend across
Lateral border of sternum to the midaxillary line
what are the two main nodal sites for lymph drainage from the breastS?
- Axillary nodes
- Internal mamillary nodes
Give 5 risk factors of breast cancer
- Late menopause
- Oral contraception
- BRCA gene mutations
4.HRT
5.Obesity
Where do breast cancers most commonly originate?
Glandular tissue -
Ductal or lobular carcinoma
Give 5 signs/symptoms of breast cancer:
- Painless lump in breast
- lump or swelling in armpit
- an eczema like rash on the nipple
- inverted nipple
- dimpling or thickening of skin/tissue of breast
When a breast lump is identified why do patients often go for an ultrasound?
To identify whether the lump is fluid filled (cyst) or mass filled (tumour)
List 4 type of surgical procedures involved in breast cancer
- lumpectomy, wide local excision
- mastectomy
- sentinel node biopsy
- axillary node dissection
What is tamoxifen
Main hormonal therapy used in breast cancer patients following primary to treatment to prevent recurrence.
Give two examples of hormone therapy drugs used for breast cancer and their mode of action.
Tamoxifen - block oestrogen receptors preventing proliferation of cancer cells
Aromatase inhibitors - reduce oestrogen production
What does HER2 stand for and how is it linked to breast cancer?
Human epidermal growth factor receptor 2
It is elevated levels in 20-30% of cancers and makes a suitable target in cancer treatment.
What is triple negative breast cancer
Breast cancer cells do not have the following receptors:
- oestrogen
- progesterone
- HER2
This makes them unsuitable for hormone therapy
What is a suitable targeted therapy for a patient who has BRCA mutation +ve cancer?
PARP inhibitors - inhibit cell repair of damaged DNA
What nodal systems are involved in breast cancer?
Axillary nodes - armpit
Sentinel nodes - type of axillary
Supraclavicular - neck above clavicle
Internal mammary nodes - near sternum
Give 5 factors that indicate poor prognosis of breast cancer
- metastatic spread
- lymph node involvement
- triple negative cancer
- high histological grade (poorly differentiated)
- Inflammatory histological type
What is SGRT
Surface guided radiotherapy
Uses 3D cameras to track movement of patient and beam on only when patient in correct position. No tattoos needed.
When is radiotherapy most commonly used in breast cancer?
Adjuvantly after primary conservative surgery
What is the precription for radical radiotherapy (normal and fast course)
40Gy in 15#
26 Gy in 5#
