Breast Flashcards
Sentinel node biopsy procedure?
- Technician sulfur colloid (search for it with gamma probe)
- Isosulfan blue (look for blue lymphatics)
Ways to sample lesion for biopsy?
- Needle localized biopsy
2. Stereotactic core biopsy (costs less, looks better, shorter recovery time)
Axilla – level I versus level II versus level III nodes?
Lateral versus under versus medial to pectoralis minor
Postmenopausal breast cancer – post-op management?
- If estrogen receptor positive, give aromatase inhibitor
2. If cancer larger than 1 cm, give chemo
Adjuvant chemotherapy for premenopausal breast cancer? Post menopausal?
Multiagent chemo
- CMF (cyclophosphamide, methotrexate, five-FU)
- AC – doxorubicin (adriamycin) and cyclophosphamide
If postmenopausal – Multiagent chemo if node positive but not absolutely necessary if node negative
Sporadic versus familial versus hereditary breast cancer?
No relatives within two generations
versus
one or more first/second degree relatives versus
Familial but at younger age, bilateral, associated with other primary tumors, autosomal dominant
Differential for bloody nipple discharge?
- Intraductal papilloma
- Paget’s disease of the nipple
- Fibercystic change
Galactogram?
Cannulation of the affected duct and injection of contrast medium
Bacteria associated with mastitis in non-breast-feeding postmenopausal women?
Differential? Work up?
Gram-negative anaerobes
Inflammatory carcinoma.
- Immediate breast ultrasound to look for abscess
- If No abscess, mammogram
Most aggressive form of breast cancer? Characteristics? Treatment?
Inflammatory cancer of the breast
- Dimpling of the skin and erythema resembling skin of an orange
- Wildly infiltrating with no palpable masses
- Invasion of dermal lymphatics (can get skin biopsy)
Multiagent chemotherapy followed by radiation and surgery