Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABSITE Flashcards > Breast > Flashcards

Breast Flashcards

1
Q

sensation to medial arm

A

intercostobrachial n. (off 2nd intercostal n), can be sacrificed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

innervation to serratus anterior; injury called?

A

long thoracic n.

winged scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

innervation to latissimus dorsi and injury?

A

thoracodorsal n.

weak arm adduction/pull ups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

innervation to pec major/pec minor

A

medial pectoral n to both

lateral pectoral n to pec minor only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Batson’s plexus

Clinical significance

A

valveless vertebral veins

allows direct mets to spine from breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Poland syndrome

A

amastia, hypoplastic shoulder, no pectoralis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mastodynia and tx?

A

Breast pain
Rx with danazol, OCP, evening primrose oil, tamoxifen (first line)
Vitamin E not useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mondor’s disease and tx

A

thrombophlebitis of superficial vein of breast
Cord like mass laterally
Rx: NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T1
T2
T3
T4

A

T1<2cm
T2 2-5 cm
T3 >5 cm
T4 skin or chest wall involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

N1
N2
N3

A

positive ax nodes
matted or fixed nodes
internal mammary nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Stage I
Stage II
Stage III
Stage IV

A

T1
up to T2N1 or T3N0
T4 or N2
Mets (include supraclavicular nodes, unlike lung cancer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Breast met MC sites

A

bone
lung
brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Her2Neu

A

marker for breast CA
implies worse prognosis
Herceptin now available for rx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Worse prognosis markers

A

Erb B 2
p53
cathepsin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long does it take approximately for tumor to grow to 1 cm?

A

approximately 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tamoxifen risks

A

Increase endometrial cancer

DVT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

increased risk of atypical hyperplasia

A

raises risk x4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

best prognosis of ER/PR

A

ER+PR+ > ER-PR+ > ER+PR- > ER-PR-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Tx of DCIS

A

Precursor for invasive carcinoma
Lumpectomy + radiation
Mastectomy for high grade/large tumor/poor margins

20
Q

Tx of LCIS

A 
30-40% develop invasive carcinoma (either breast)
Tx options:
-nothing
-tamoxifen
-b/l mastectomy
21
Q

Comedo breast cancer tx

A

Mastectomy

Poor prognosis

22
Q

Paget’s disease of the breast

A

Eczematous lesions on nipple, there is underlying DCIS or ductal CA

23
Q

Cystosarcoma phyllodes (phyllodes tumor) and tx?

A

10% malignant
Rare nodal mets
HEMATOGENOUS spread (not lymphatic) because it’s a SARCOMA

Tx: WLE, no ALND

24
Q

BRCA risk of cancer

A

85% have CA by age 70
BRCA1 ovarian CA (50%)
BRCA2 male breast CA

25
Q

Indications for radiation after mastectomy

A

> 4 nodes
Skin or chest wall involvement
+margins

26
Q

Stewart Treves syndrome (cutaneous angiosarcoma)

A

Lymphangiosarcoma in lymphedematous limb, presents with purplish mass on arm ~10 yrs s/p MRM

27
Q

Bloody nipple discharge

A 
intraductal papilloma
no risk of CA
#1 cause of bloody nipple discharge, 1/2 are serous though
28
Q

BRCA 1

A 
Chromosome 17
Risk of colon ca
Earlier age of onset
60% risk of breast cancer
40% risk of ovarian cancer
29
Q

BRCA 2

A

Chromosome 13
Male breast cancer
Older age onset >50 yo
Risk of bladder/pancreatic cancer

30
Q

Who should get screening breast MRI?

A

Patients with lifetime risk exceeding 20-25%

  • strong family hx
  • prior tx of Hodgkin disease with mantle radiation
  • BRCA mutation
31
Q

Pleomorphic LCIS tx

A

different from classic LCIS
more similar to DCIS and invasive lobular carcinoma
excisional biopsy should be performed of the lesions with wire localization

32
Q

Proper test for suspected Paget’s disease?

A

Full thickness nipple biopsy to confirm Paget’s first - then proceed with partial or total mastectomy once confirmed

85-92% of women with Paget’s have breast cancer

33
Q

Which lesions are associated with increased breast cancer risk?

  • atypical ductal hyperplasia
  • sclerosing adenosis
  • fat necrosis
  • complex sclerosing lesion
  • radial scars
A

Atypical ductal hyperplasia - 4 fold increased risk of developing breast cancer

34
Q

Granulomatous mastitis sx and tx

A

idiopathic inflammatory condition
often presents with abscesses and fistulas

tx: core biopsy, observation and course of steroids, surgical excision for steroid refractory patients

35
Q

First line treatment for gynecomastia

A

Anti-estrogen treatments - tamoxifen

Surgery for those who do not respond to medical treatment - liposuction or removal of glandular breast tissue through periareolar incision

36
Q

Hormone replacement therapy affect on breast cancer risk

A

OCP use slightly increases risk of breast cancer - 10 years after cessation of birth control pills, the risk returns to baseline

Combination hormone therapy increases risk of breast cancer and CV disease in post-menopausal women

37
Q

Periareolar mammary duct fistula

A

Chronically discharging nipple lesion, tracks to a major subareolar milk duct

Recurring abscesses will drain along the tract, forming a chronic fistula

Tx: excision of entire fistula tract - can be closed primarily if there is no acute infection

38
Q

Risk of lymphedema with SLNB vs ax dissection

A

7% risk in SLNB 6 months after surgery

20% risk in ax dissection

39
Q

Tumor emboli in the dermal lymphatic channels

A

Pathognomonic histologic finding of inflammatory breast cancer

40
Q

Tx of inflammatory breast cancer

A

Neoadjuvant chemo
MRM
Post-op radiation

41
Q

Tx of locally advanced non-inflammatory breast cancer

A

Neoadjuvant chemo
Can attempt BCT
Post-op radiation

42
Q

Pregnancy associated breast cancer treatment

A

Surgery is 1st line treatment - can be performed safely at any trimester (mastectomy or BCT)
SLNB is ok during pregnancy - radioisotope stays trapped at injection site until decay occurs, half life is 6 hours

Chemotherapy can be given after the 1st trimester adjuvant or neoadjuvant

Tamoxifen should be delayed until after delivery

43
Q

Subareolar breast abscess treatment

A

US to differentiate between mastitis and breast abscess

MRSA coverage with abx tx - continued until complete clinical resolution

US guided aspiration of abscess for simple abscess

Surgical I/D for multiloculated or recurrent abscess

44
Q

Fibroadenoma histologic elements

A

Stromal and epithelial tissue

Similar histologically to phyllodes tumor

45
Q

Phyllodes tumors dx and tx

A

Benign vs malignant differentiation - molecular analysis
Hematogenous spread - SLNB not indicated
1 cm margin for malignant phyllodes tumor - can pursue BCT
50% local recurrence rate

46
Q

Which BIRADs classifications require biopsy?

A

4 and 5
If BIRADS5 biopsy is benign - discordant results and should proceed with surgical excisional biopsy to confirm
BIRADS4 lesions is benign on biopsy - ok to observe

47
Q

BIRADS classifications

A 
0 - inconclusive
1 - negative
2- benign
3 - probably benign
4 - suspicious
5 - highly suggestive of malignancy
6 - biopsy proven malignancy

ABSITE Flashcards (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions