Breast Flashcards
what is the most common benign neoplasm of the breast
fibroadenoma
when are fibroadenomas most common
early reproductive years of a womans life
what are the typical features of a papilloma
can occur within a cyst and is often associated with bloody cyst fluid
what is the most common aetiology of spontatneous nipple discharge
intraductal papilloma or papillomas
what is pagets disease a variant of
ductal carcinoma
how can pagets disease present
as an erythematous weeping lesion on the surface of the nipple and areola, although it usually presents as a dry, scaly erythematous lesion
should breastfeeding be continued if the mother has mastitis
yes
how is mastitis treated
flucloxacillin or augmentin
how often should the patient be examined if they have mastitis
every 3 days to be certain the infection is responding to treatment and there is no evidence of abscess formation
why is being overweight a risk factor for breast cancer
it causes more oestrogen to be produced
where does carcinoma of the breast arise from `
the lining epithelium of the duct system
which cells is testosterone produced in
Leydig cells
How is NPI calculated
tumour size (x 0.2) + lymph node score + grade score
how are lymph nodes scored
0 involved=1
1-3 lymph nodes=2
3 or more=3
do you give radiotherapy for DCIS
yes after the area has been surgically removed
when do you give a boost to the tumour bed
if women under 54 on day of surgery
posterior margins <1mm for invasive disease after full thickness excision
when do you give chest wall radiotherapy
tumour ize >5cm
4 or more involved nodes
involved resected margins
t4 disease
when do you give radiotherapy to ipsilateral axilla
> 1 positive macrometastases sentinel node
extensive ECS post clearance
when do you give radio to supraclavicular fossa
> 4 involved nodes
describe the secretory tissue of the breast
15-25 lobes each consisting of a compound tubule-acinar gland which drains via a series of ducts leading to the nipple
what is adjacent to secretory lobules
dense fibrous tissue which is surrounded by adipose tissue
what is the basic functional secretory unit
terminal duct lobular unit
describe the histology of the nipple
thin, highly pigmented keratinized stratified squamous epithelium with a dense core of irregular connective tissue
how does the breast change during menstrual cycle
epithelial cells increase in height
lumina of ducts become enlarged
small amount of secretions in the ducts
