Breast Flashcards
Mastitis occurs most commonly in which population of women
Lactating and premenopausal women
The most common cause of mastitis is
Staphylococcal infection
Options for draining breast abscesses include(2):
I+D or needle aspiration under ultrasound
–aspiration may not be successful of loculations are present
It’s important to differentiate inflammatory breast cancer from mastitis. When should cancer be suspected (3)?
What should be done if cancer is suspected?
If the patient is post menopausal, they have no predisposing factors, or they are not responding to treatment
A biopsy should be done
Bloody nipple discharge is commonly the result of what pathology?
What is the best imaging modality for this?
Intraductal papilloma
Ductography
In which patients is it inappropriate to use the Gail model?
In women with a known BRCA mutation or women with lobular or ductal carcinoma in situ
What are the borders of the mature female breast?
Superiorly: 2nd or 3rd rib
Inferiorly: inframammary fold at the 6th or 7th rib
Laterally: lateral border of sternum
Medially: anterior axillary line
Deep/posterior: pectoralis major, sertatus, and external oblique muscles
Blood supply of the breast is
Internal mammary artery, posterior intercostal arteries, and axillary artery (highest thoracic, lateral thoracic, and pectoral branches of the thoracoacromial artery
Sensory innervation of the breast includes:
Lateral cutaneous branches of the 3rd-6th intercostal nerves and anterior branches of the supraclavicular nerve
What’s the intercostobrachial nerve? Why is it important?
It is the lateral cutaneous branch of the 2nd intercostal nerve.
It may be seen during dissection of the axillary. Resection of the nerve causes loss of sensation over medial aspect of upper arm
What are the 6 axillary LN groups recognized by most surgeons?
Axillary vein group (lateral), external mammary group (anterior), scapular group (posterior), central group, subclavicular group (apical), and interpectoral group (Rotter’s nodes)
What’s Mondor’s disease? How is it treated?
Thromophlebitis of the superficial veins of the anterior chest wall.
Treatment: NSAIDs and warm compresses
Most frequently involved veins of Mondor’s disease are
Thoracoepigastric, lateral thoracic, and superficial epigastric veins
Lymph node groups are assigned levels according to their anatomic relationship to what? How many groups are there?
The pectoralis minor muscle
Three groups
Level I LN are where? Which LN groups do they contain?
Located lateral to or below the pec minor
Groups: axillary vein, external mammary, and scapular groups