Breast

Question 1

Tx for intraductal papilloma?

Answer 1

Duct excision

Question 2

Most common cause of bloody nipple discharge?

Answer 2

intraductal papilloma

Question 3

What causes the skin thickening and other physical findings of inflamm breast ca?

Answer 3

Blockage of dermal lymphatics by tumor cells

Question 4

What age do screening mammograms start?

Answer 4

age 40

Question 5

Who should get breast MRI?

Answer 5

High risk patients, ie those with >20% lifetime breast Ca risk

Question 6

What screening is required for pts with hereditary breast Ca syndromes?

Answer 6

Annual screening with imaging starting at age 25. MRI only from 25-29 then add mammo as well at age 30.

Question 7

Contraindications to radiation?

Answer 7

connective tissue dz, early pregnancy (rads would be required while patient was still pregnant)

Question 8

Contraindications to breast conservation?

Answer 8

tumor > 5 cm, contraindication to radiation, chest wall invasion, inflammatory breast cancer

Question 9

When is chemo safe in pregnancy?

Answer 9

after first trimester

Question 10

traztuzumab is?

Answer 10

AKA herceptin, used for HER2 + cancers

Question 11

Is hormonal/immunotherapy safe during pregnancy?

Answer 11

no

Question 12

tx of inflamm breast ca?

Answer 12

neoadjuvant chemotherapy then MRM then radiation

Question 13

What does post mastectomy lymphangiosarcoma (Stewart-Treves) look like?

Answer 13

usually like bruises or blotches or erythema

Question 14

Tx for lymphangiosarcoma?

Answer 14

WLE with 3-6 cm margins of normal skin

Question 15

When should orchiectomy be performed in male patients with breast Ca?

Answer 15

ER+ metastatic dz

Question 16

How to distinguish between fibroadenoma and phyllodes tumor?

Answer 16

fibroadenoma is slow growing and phyllodes is rapidly expanding. Fast growing smooth, round breast tumors should undergo core needle bx

Question 17

Resection margin for phyllodes tumor?

Answer 17

1-2 cm normal breast tissue

Question 18

Resection margin for invasive breast cancer?

Answer 18

2-3 mm

Question 19

Most common breast infection organism?

Answer 19

Staph aureus

Question 20

Is LCIS a premalignant lesion?

Answer 20

No, it is a tumor marker for increased susceptibility to breast cancer

Question 21

What is Mondor dz?

Answer 21

thrombophlebitis of the subQ veins of the anterior chest wall. Presents with a tender, red, subQ cord at the lateral aspect of the breast. Tx with NSAIDs and warm compresses for 6 weeks.