Breast

Question 1

What are the 2 main causes of Mastitis?

Answer 1

Lactation

Duct Ectasia

Question 2

What is the most common breast cancer?

Answer 2

Breast carcinoma (addenocarcinoma)

Question 3

What age is the peak for breast cancer?

Answer 3

60-70

Question 4

How does breast screening work?

Answer 4

Ages 50-70

every 3 years get a MXR

Question 5

How is the grade of a tumour assessed?

what value indicates low, medium, high grade

Answer 5

nuclear pleomorphism
tubular differentiation
mitotic activity

all get score /3 giving a total score out of 9

3-5 low
6-7 intermediate
8-9 high

Question 6

What effect does ER expression have on prognosis?

Answer 6

Positive

Question 7

What effect does PgR expression have on prognosis?

Answer 7

Positive

Question 8

What effect does HER2 expression have on prognosis?

Answer 8

Negative

Question 9

What receptor expression has the worst prognosis?

Answer 9

Triple negative

ER, PR, HER2

Question 10

What receptor expression has the best prognosis?

Answer 10

ER +’ve
PR +’ve
HER2 -‘ve

Question 11

Name 4 poor prognostic indicators in breast cancer?

Answer 11

<35
HER2 +’ve
ER -‘ve
lymph node positive

Question 12

What are some risk factors for breast cancer?

Answer 12

age >55
early menarche, late menopause 
not breastfeeding 
nulliparity, late age @ 1st born >35
Hx of breast cancer, radiotherapy
Long term use of COCP
Use of HRT
obesity, smoking, alcohol 
mutations BRCA 1/2, TP53

Question 13

At what age does DCIS normally develop?

Answer 13

> 50

Question 14

Anatomically where does the breast lie?

Answer 14

ribs 2-6

lateral border of sternum to mid axillary line

Question 15

What muscles do breast sit over?

Answer 15

Pectoralis major

serratus anterior

Question 16

What is the space between the fascia and breast tissue called?

Answer 16

retromammary space

Question 17

The first breastmilk a mother makes is called what?

Answer 17

Colostrum

Question 18

Colostrum contains what?

Answer 18

high levels of lactoferrin which helps the baby colonise with normal bacteria

Question 19

Milk ejection is controlled by what?

Answer 19

oxytocin

Question 20

Milk production is controlled by what?

Answer 20

protlactin

Question 21

prolactin is released from the ______ pituitary

Answer 21

anterior

Question 22

Oxytocin is released from the ______ pituitary

Answer 22

posterior

Question 23

What stimulus causes the release of milk?

Answer 23

suckling - hypothalamus to release oxytocin - causing milk ejection