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Year 4 > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

type of glands in breast?

A

apocrine

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2
Q

lymphatic drainage of breast?

A

99% drains to axilla

small bit goes to internal mammary/parasternal nodes

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3
Q

main presenting features of breast cancers?

A

lump
pain
nipple discharge
skin/nipple change

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4
Q

risk factors for breast cancer?

A

previous breast disease
fam history (BRCA1, BrCA2, P53)
drug history

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5
Q

whats involved in triple assessment?

A

examination
imaging (mammogram/US/MRI)
tissue biopsy (FNA/core/vacuum assisted)

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6
Q

who gets mammograms and who gets US?

A

> 40 = mammogram
<40 = US
symptomatic men also get mammogram

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7
Q

how often can mammogram be done?

A

once a year

need a good reason to do one again if ones been done in past 6 months (due to high radiation)

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8
Q

when is US used?

A

not used for general screening
in women <40 if they have a reason to get a scan (eg a lump)
also used in combination with mammogram in symptomatic patients
can also be used to guide biopsy or drainage of cyst/abscess

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9
Q

when is MRI used?

A

only really used if theres a big discrepancy between examination/mammogram/US
also used for screening in BRCA +ve people (reduces added risk of repeated radiation)
good detail, picks up everything regardless of tissue density

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10
Q

why is FNA not the best biopsy?

A

doesnt show whether in situ or invasive

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11
Q

core vs vacuum biopsy?

A

both can show whether cancerous cells have invaded basement membrane
vacuum needs US guidance (not sure if core does too)
vacuum can remove whole lesion but is much more expensive

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12
Q

most common cause of discrete lump?

A

fibroadenosis or benign breast change

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13
Q

triple assessment if <40?

A

examination + US + core biopsy

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14
Q

triple assessment if >40?

A

examination + mammogram + US + core biopsy

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15
Q

most common benign breast diseases in <25?

A

juvenile hypertrophy

fibroadenoma

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16
Q

most common benign breast diseases in 25-40?

A

mastalgia

cyclical nodularity

17
Q

most common benign breast disease in 35-55?

A

cysts
duct ectasia
sclerosing lesions

18
Q

types of congenital breast disease?

A

extra nipples
accessory breasts (usually in axilla)
absence of hypoplasia of breast (including asymmetry)
chest wall abnormalities

19
Q

what is juvenile hypertrophy?

A

uncontrolled growth of breast tissue in the absence of any endocrine abnormality
some may require surgery

20
Q

most common benign neoplasm?

A

fibroadenoma

21
Q

presenting features of fibroadenoma?

A

most common in 15-25

painless, smooth, firm and very mobile lump

22
Q

what is phylodes tumour?

A

rare fibroepithelial neoplasm with rapid growth
can become malignant cytosarcoma and metastasise via blood
needs wide local excision with clear margins

23
Q

most common cause of breast abscess?

A

staph aureus (usually related to lactation)

24
Q

management of breast abscess?

A

US guided percutaneous drainage, antibiotics, continue breast feeding
if not resolving in 2 weeks then do excisional biopsy to rule out inflammatory breast cancer

25
Q

what is duct ectasia?

A

major sub-areolar ducts dilate and shorten during normal involution as part of normal ageing
ducts often clog up causing infection, discharge and abscesses

26
Q

who is duct ectasia worse in?

A

smokers

27
Q

management of duct ectasia?

A

reassure
manage infections
stop smoking

28
Q

features of creast cysts?

A

usually smooth discrete lumps
can be painful
characteristic halo on mammogram
distended, fluid filled lobule on US

29
Q

management of breast cysts?

A

conservative

30
Q

what is duct papilloma?

A

isolated wart like structure within major subareolar ducts
presents as single duct watery or bloodstained nipple discharge
not premalignant

31
Q

how are duct papillomas managed?

A

should be removed as can undergo atypical change (although not actually pre-malignant)
total duct excision
microductectomy (in young patients who wish to breastfeed at a later age)

32
Q

presenting features of duct papilloma?

A

older women
warty thing inside duct
may feel lump but not always
usually see lump on US

33
Q

biggest risk for breast cancer?

A

oetrogen exposure

34
Q

most common breast cancer type?

A

ductal

35
Q

which BRCA mutation is more common and dangerous?

A

BRCA1

36
Q

how is wide local excision done?

A

excise tumour with 1cm margins

radiotherapy given to everyone post surgery

37
Q

is radiotherapy given after mastectomy?

A

if high risk

38
Q

best prognostic indicator of long term survival?

A

status of axilla lymph nodes

39
Q

age for screening?

A

50-70

Year 4 (83 decks)

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