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Surgery > Breast > Flashcards

Breast Flashcards

1
Q

at what week of gestation does mammary ridges appear?

A

5th or 6th week of gestation

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2
Q

___ syndrome is associated with amastia

A

poland syndrome

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3
Q

the breast is composed of how many lobes?

A

15 to 20 lobes

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4
Q

this quadrant contains the greater volume of tissue compared to all other quadrants

A

upper outer quadrants

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5
Q

___ artery are the perforators of the breast

A

internal mammary artery

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6
Q

blood supply of the breast

A

internal mammary artery
posterior intercostal artery
branches from axillary artery

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7
Q

this provides a route for breast cancer metastatsis to the vertebra

A

batson vertebral plexus

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8
Q

batson vertebral plexus extends from the ___

A

base of the skull of the sacrum

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9
Q

What innervates the breast?

A
  1. lateral cutaneous branch from the 3rd to 6th intercostal nerves
  2. Intercostobrachial nerve (from the 2nd intercostal nerve)
  3. Supraclavicular nerve from the cervical plexus
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10
Q

Level I breast lymphatics are composed of

A
  1. Scapular group
  2. External mammary group
  3. Axillary vein grooup
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11
Q

Level II breast lymphatics are composed on

A
  1. central group

2. Interpectoral group

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12
Q

Rotter nodes are also called

A

interpectoral group

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13
Q

Level III breast lymphatics are composed of

A

Subclavicular group

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14
Q

Estrogen plays a role ____ development

A

ductal development

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15
Q

Progesterone plays a role in ____

A

lobular development

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16
Q

____ plays a role in lactogenesis

A

prolactin

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17
Q

___ syndrome predisposes a male to breast cancer

A

Klinefleter syndrome

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18
Q

[Gynecomastia Grading]

mild enlargement without skin redundancy

A

Grade I

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19
Q

[Gynecomastia Grading]

moderate breast enlargement without skin redundancy

A

Grade IIa

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20
Q

[Gynecomastia Grading]

moderate enlargement with skin redundancy

A

Grade IIb

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21
Q

[Gynecomastia Grading]

marked enlargement with skin redundancy and ptosis

A

Grade III

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22
Q

Drug treatment for gynecomastia

A

Danazol

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23
Q

[pharma]

drug of choice for gynecomastia with androgen deficiency

A

testosterone administration

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24
Q

Etiologic agent for epidemic puerperal mastitis via the suckling neonate

A

MRSA

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25
Q

Etiologic agent for non-epidemic mastitis

A

S. aureus.

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26
Q

___ is also called recurrent peri-ductal mastitis

A

Zuska Disease

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27
Q

Recurrent retroareaolar infections and abscesses of the periductal mastitits

A

zuska disease

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28
Q

Variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast

A

mondor disease

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29
Q

[diagnose]

acute pain at the lateral aspect of the breast, tender, firm cord following the distribution of the veins

A

mondor disease

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30
Q

[Is there a risk for malignancy in this lesion?]

mild ductal epithelial hyperplasia

A

none

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31
Q

[Is there a risk for malignancy in this lesion?]

duct ectasia

A

none

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32
Q

[Is there a risk for malignancy in this lesion?]

sclerosing adenosis

A

no to slightly increased risk

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33
Q

[Is there a risk for malignancy in this lesion?]

florid ductal epithelial hyperlasia

A

no to slightly increased risk

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34
Q

[Is there a risk for malignancy in this lesion?]

intraductal papillomas

A

no to slightly increased risk

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35
Q

[diagnose]

well-defined mass, UO quadrant, enlarges before the onset of her period

A

fibrocystic disease of he breast

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36
Q

most common cause of bloody nipple discharge

A

intraductal papilloma

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37
Q

[diagnose]

well circumscribed painless rubbery movable discrete borders

A

fibroadenoma

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38
Q

Smoking ___ (is/ is not) a risk factor for breast CA

A

not a risk factor

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39
Q

At what age will you request for a baseline mammogram

A

35

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40
Q

annual mammogram shall be done beginning ___ age

A

40

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41
Q

[BRCA Mutations]

BRCA 1 is located in what chromosome?

A

Chr 17

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42
Q

[BRCA Mutations]

this is associated with poorly differentiated CA and hormone receptor negative

A

BRCA 1

43
Q

[BRCA Mutations]

early onset, bilateral disease
CA at other sites

A

BRCA 1

44
Q

[BRCA Mutations]

BRCA II is located in what chromosome?

A

Chromosome 13

45
Q

[BRCA Mutations]

Associated with breast CA in men

A

BRCA II

46
Q

[BRCA Mutations]

this is associated with well differentiated CA
and express hormone receptor

A

BRCA II

47
Q

[BRCA Mutations]

Age at which mammogram should be done yearly

A

25

48
Q

[BRCA Mutations]

age at which CA 125 yearly beginning at age 25

A

25 years old

49
Q

If the mass is around 1cm, it has been present for how many years?

A

5 years

50
Q

Nipple changes in breast CA is due to

A

shortening of coopers sensory ligament

51
Q

it is the most important prognostic correlate of disease-free and overall survival

A

axillary lymph node status

52
Q

Peau d orang e is due to

A

blockage of lymph node drainage

53
Q

Metastatic foci occirs when the primary Ca exceeds in ___ cm

A

0.5

54
Q

[Primary Breast CA]

originates from the terminal duct lobular units

(+) neighborhood calcifications
marker of increased risk for invasive CA

A

LCIS

55
Q

[Primary Breast CA]

due to proliferation of the epithelium

calcification occurs in the areas of necrosis

A

DCIS

56
Q

[Primary Breast CA]

a true anatomic precursor of invasive CA

A

DCIS

57
Q

[Primary Breast CA]

paget disease is associated with this CA

A

DCIS

58
Q

[Primary Breast CA]

In lobular CA, the subsequent cancers is located

A

bilaterally

59
Q

[invasive breast CA]

large, pale, vacuolated cells in the rete pegs of epithelium

(+) CEA
(-) S-100

A

Paget disease

(+) S-100 - melanoma

60
Q

most common type of invasive breast CA

A

invasive ductal CA

61
Q

[diagnose]

central stellate configuration with chalky white or yellow streaks

A

invasive ductal CA

62
Q

[invasive breast CA]

this is the frequent phenotype of BRCA1 cancers

A

medullary CA

63
Q

[diagnose]

mass that is soft, hemorrhagic, bulky

dense lymphoreticular infiltrate of lymphocytes and plasma cells

large pleomorphic nuclei that are poorly differentiated sheet-like growth pattern

A

medullary CA

64
Q

[invasive breast CA]

usually seen in elderly population

glistening and gelatinous mass

A

colloid CA

65
Q

[invasive breast CA]

presents in 70 year old woman, small, rarely attain a size of 3cm

A

papillary CA

66
Q

[invasive breast CA]

perimenopausal or early menopausal periods

distant metastasis are ra

haphazard array of small tubular elements

A

tubular CA

67
Q

[invasive breast CA]

absence of E-cadherin

A

invasive lobular CA

68
Q

[invasive breast CA]

small cells arranged in single file orientation

intracytoplasmic mucin that may display the nucleus (signet ring CA)

A

invasive lobular CA

69
Q

Cite the risk factors of breast CA

A
  1. increased estrogen exposure
  2. Radiation exposure
  3. increased alcohol intake
  4. high fat diet
  5. prolonged OCP use
  6. Prolonged HRT use
  7. Family history
70
Q

Cite the specific mammographic features of malignant breast CA

A
  1. Solid mass with or without stellate features
  2. Asymmetric thickening of tissues
  3. clustered microcaclficiations
71
Q

[BIRADS Category]

probably benign
<2% risk of malignancy

A

BIRADS 3

72
Q

[BIRADS Category]

Recommendation for BIRADS 3

A

short interval follow-up every 6 months, then every 6 to 12 months

73
Q

What BIRADS category will you perform biopsy (needle)

A

BIRADS 4A, B, C

74
Q

What is the primary indication for ductography

A

nipple discharge especially when the fluid contains blood

75
Q

Imaging modality for younger females to screen for breast CA

A

UTZ

76
Q

What is the screening modality for women with BRCA mutation?

A

MRI

77
Q

diagnostic modality for premenopausal woman with a family history of breast CA

A

breast UTZ

78
Q

ER/PR flow studies can be done in this type of breast biopsy technique

A

incisional biopsy

excisional biopsy

79
Q

breast biopsy technique used for non-palpable masses

A

wire or needle directed excisional biopsy

80
Q

[Breast CA Staging]

T2 N1 M0

A

T2: Tumor is greater than 2 cm but less than 5cm

N1 : mets movable ipsilateral ALN

81
Q

[Breast CA Staging]

N3 means

A

mets in ipsilateral ALN and internal mammary LN or inflaclavicular LN or supraclavicular LN

82
Q

[SLNB Recommendations]

SLNB negative

A

No further axillary dissection

83
Q

[SLNB Recommendations]

SLNB positive

200 cells, larger than 0.2mm, but none larger than 2.0mm

A

no further LN dissection

84
Q

[SLNB Recommendations]

SLNB positive
but T1 or T2, 1 or 2 positive sentinel LN
Breast conserving surgery, Whole-breast RT planned, no preopeartive chemo

A

No further LN dissection

85
Q

[SLNB Recommendations]

SLNB not identified

A

do Axillary LN dissection

86
Q

[Type of mastectomy]

Simple Mastectomy +
Removal of axillary LN
+ removal of pectoralis minor

A

MRM, Patey

87
Q

[Type of mastectomy]

Simple Mastectomy +
Removal of axillary LN
+ preserve pectoralis minor

A

MRM, Madden and Auchinocloss

88
Q

[Type of mastectomy]

Simple Mastectomy +
Removal of axillary LN
+ transect pectoralis minor then repair of transected muscle

A

MRM, scanlon

89
Q

[Type of mastextomy]

Remove entire breast, axillary LN,

+ Pectoral Minor + Pectoral major

A

Radical Mastectomy

90
Q

[complications of mastectomy]

Protraction of scapula: ___ nerve and muscle

A

Long thoracic, serratus anterior

91
Q

[complications of mastectomy]

Extension and adduction of shoulder: ___ : _____

A

Thoracodorsal, latissimus dorsi

92
Q

[complications of mastectomy]

The pectoralis minor and major are damaged. What nerve is affected?

A

lateral pectoral nerve

93
Q

[complications of mastectomy]

loss of sensation of medial upper arm

A

intercostobrachial

94
Q

[Advanced locoregional breast CA]

Neoadjuvant chemotherapy is indicated in what stages of CA

A

Stage IIIa, Stage IIIb

95
Q

Most common site of breast CA metastasis

A

Liver, Lungs

96
Q

Breast cancer treatment during the 1st and 2nd trimester

A

MRM

97
Q

breast CA treatment in 3rd trimester?

A

BCS

98
Q

[Follow-up after treatment]

In the first 2 years

A

every 4 months

99
Q

[Follow-up after treatment]

In the next 3 years (after 2 years of treatment)

A

every 6 months

100
Q

[Follow-up after treatment]

Mammogram of the contralateral breast is done every ____

A

yearly

101
Q

[Type of mastectomy]

Modified radical mastectomy removes axillary LN level ___ and ____

A

Level I and II

102
Q

[Type of mastectomy]

This type removes

ALL breast tissue, skin, NAC
pectoralis major
pectoralis minor
level I, II and III LN

A

Halsted Radical Mastectomy

103
Q

___ drugs used for medical adrenalectomy

A

anastrazole

104
Q

drug that inhibits production of adrenal steroids and conversion of androgens to estrogens in the adrenal gland and peripherally

A

anastrazole

Surgery (19 decks)

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