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Breast > Breast Basics > Flashcards

Breast Basics Flashcards

1
Q

What is a triple breast assessment?

A
  1. Clinical assessment
  2. Imaging assessment
  3. Needle biopsy
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2
Q

What does each category of the 1-5 scale mean in a breast triple assessment?

A 
1 - Normal
2 - Benign
3 - indeterminate/probably benign
4 - suspicious 
5 - malignant
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3
Q

What does the prefix ‘P’ mean in triple assessment?

A

Palpation

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4
Q

What does the prefix ‘M’ mean in triple assessment?

A

Mammography

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5
Q

What is the lifetime risk of developing breast cancer?

A

1 in 8 women will get breast cancer in their lifetime

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6
Q

What are the 2 main factors that increase the risk of developing breast cancer?

A
  1. Female gender

2. Increasing age

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7
Q

Which 2 reproductive risk factors increase the risk of developing breast cancer?

A
  1. Earlier Menarche

2. HRT use

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8
Q

Which 3 reproductive risk factors reduce the risk of developing breast cancer in women?

A
  1. Earlier age at first birth
  2. Increasing parity
  3. Longer duration of breastfeeding
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9
Q

What is important to clarify in a breast cancer FHx?

A
  1. The age at which family members had breast cancer
  2. Whether the family members affected are 1st, 2nd or 3rd degree relatives
  3. How many family members have had breast cancer
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10
Q

What percentage of breast cancer cases have been deemed preventable by Cancer Research?

A

23%

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11
Q

What are 2 common risk factors for breast cancer that are preventable?

A
  1. Excessive alcohol intake

2. Excessive body fat (being overweight)

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12
Q

What is Paget’s disease of the nipple?

A

A rare form of breast cancer which causes eczema-like changes to the nipple and areola

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13
Q

What percentage of patients suffer from lymphoedema following lymph node clearance after mastectomy?

A

20%

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14
Q

What are accessory nipples?

A

Embryonic remnants of the mammary ridge.

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15
Q

What is a mammogram?

A

An X-Ray of the breasts

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16
Q

What are the 2 views of the breasts that are taken during a mammogram?

A
  1. Mediolateral Oblique (MLO)

2. Craniocaudal (CC)

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17
Q

Why are the breasts compressed during a mammogram (4 reasons)?

A
  1. This spreads out the glandular tissue of the breast, reducing the risk of missing structures due to an obstructed view
  2. The compression holds the breasts still to get a clear image
  3. It allows for uniform exposure
  4. It reduces the radiation dose to the individual having the mammogram
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18
Q

Which types of tissue makes the mammogram less effective in detecting signs of breast cancer?

A

Denser breasts with higher proportions of fibroglandular tissue compared to fat

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19
Q

Which women tend to have denser breasts?

A

Younger women

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20
Q

What imaging is first line in a young woman presenting with a need for breast imaging?

A

USS of the breasts

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21
Q

From what age is mammogram more commonly used?

A

Aged 40

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22
Q

Why is gel used under the transducer probe?

A

This excludes the tiny layer of air between the probe and the skin

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23
Q

What does the prefix ‘U’ mean in a triple breast assessment?

A

Ultrasound

24
Q

Describe the shape and margins of a; benign mass

A

Round/ovoid shape

Well-defined borders

25
Q

Describe the shape and margins of a; malignant mass

A

Irregular shape

Ill-defined margins

26
Q

How is Fine Needle Aspiration Cytology (FNA/FNAC) carried out?

A

A needle is attached to a syringe
The needle is introduced into the lesion and multiple passes are made throughout the lesion whilst suction is applied to collect a sample

27
Q

How is a FNC assessed?

A

The lesion aspirate is spread onto microscopic slides and sprayed for analysis

28
Q

What is the normal appearance of breast ductal epithelial cells?

A

Uniform size and appearance

Contain regular round nuclei

29
Q

What is the appearance of malignant breast carcinoma cells?

A

Cells scattered
Cells contain variably-sized, atypical irregular nuclei
The background contains debris - Karyorrhexis (Nuclei breakdown)

30
Q

What does the prefix ‘C’ mean in triple assessment?

A

Cytology

31
Q

How does the scoring in triple assessment for cytology differ?

A

C1 means that the sample is inadequate and needs repeating

A benign lesion is C2

32
Q

What is a core biopsy?

A

The use of a needle firing automated gun that retrieves multiple cores of tissue from the breast lesion for analysis

33
Q

What does the prefix ‘B’ mean in triple assessment?

A

Biopsy

34
Q

How does the B5 scoring system differ from other parts of the triple assessment scoring?

A

B5 is split into 2
B5a - non-invasive
B5b - Invasive

35
Q

What are the advantages of FNA?

A
  1. Quick and easy to perform
  2. Processing time is rapid (as quickly as 30 mins)
  3. Low-cost procedure
  4. Few complications
36
Q

What are the disadvantages of FNA?

A
  1. Requires a highly trained pathologist to interpret
  2. Difficult to classify a malignant lesion as invasive or non-invasive
  3. Cytology does not provide the same amount of tissue as a core biopsy
  4. Cytology cannot ascertain the receptor status of a cancer
37
Q

Where does the female breast extend between (ribs)?

A

From the 2nd rib to the 6th rib.

38
Q

Where is the medial aspect of the breast?

A

The lateral sternal edge

39
Q

Where is the lateral edge of the breast?

A

The mid-axillary line

40
Q

What is the name for the axillary tail of the breast?

A

The tail of Spence

41
Q

Which muscle does the tail of Spence run towards?

A

The lower border of pectoralis major

42
Q

How many lobes are present in each breast?

A

15-20 lobes

43
Q

How many lobules are present in each breast lobe?

A

20-40

44
Q

What are Cooper’s ligaments?

A

Thin sheets of fascia that extend like a mesh through the breast parenchyma, attaching to the dermis and the superficial and deep fascial layers

45
Q

The breast is supplied by an anastomotic network, which arteries form this anastamosis?

A
  1. Branches of the axillary artery
  2. Perforating branches of the intercostal arteries
  3. Perforating branches of the internal mammary artery (internal thoracic)
46
Q

What are the 2 main groups of lymph nodes that drain the breast?

A
  1. Axillary

2. Internal mammary

47
Q

What percentage of the lymphatic drainage goes to the axillary lymph nodes?

A

75% (3/4)

48
Q

There are three levels to the axillary nodes, what does the following level mean; Level 1?

A

Nodes inferior to pectoralis minor

49
Q

There are three levels to the axillary nodes, what does the following level mean; Level 2?

A

Nodes behind pectoralis minor

50
Q

There are three levels to the axillary nodes, what does the following level mean; Level 3?

A

Nodes above pectoralis minor

51
Q

Where do Medial breast tumours more commonly drain to?

A

The internal mammary nodes

52
Q

Where is breast cancer thought to originate from?

A

The terminal duct lobular unit (TDLU)

53
Q

Which 2 hormones influence the proliferation and branching of the ductal system?

A

Predominantly oestrogen but progesterone too

54
Q

When does the full functional development of the breast occur?

A

With hormonal changes of pregnancy and lactation

55
Q

Name the most common lactogenic hormone.

A

Prolactin

56
Q

Which hormone is release in response to suckling of the nipple by a baby?

A

Oxytocin

57
Q

What does Oxytocin do?

A
  1. Causes contraction of the myoepithelial cells to increase milk supply
  2. Mediates the secretion of prolactin

Breast (7 decks)

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