Breast Conditions

Question 1

Radiotherapy for what is a risk factor?

Answer 1

Hodgkin’s disease

Question 2

What is the most sensitive imaging?

Answer 2

mammography BUT not in younger women due to increased glandular tissue

Question 3

What is ultrasound useful for ?

Answer 3

breast lumps/guidance for biopsy. also differentiating solid/cystic

Question 4

Most common presentation?

Answer 4

lump, next most common is mastalgia (persistent unilateral pain)

Question 5

Surgical options for breast cancer?

Answer 5

Mastectomy (Mx)

Wide Local Excision (WLE)

Question 6

Surgical options for axilla?

Answer 6

Axillary Node Clearance (ANC)
Axillary Node Sampling (ANS)
Sentinel Lymph Node Biopsy (SNBx)

Question 7

Who gets radiotherapy after WLE?

Answer 7

All patients after WLE as adjuvant treatment

Question 8

What increases benefits of chemo?

Answer 8

Benefits greatest in younger women

Benefit increases with increasing adverse prognostic factor

Question 9

Describe the hormone therapy treatment options, surgical and non surgical.

Answer 9

Non-Invasive (Chemical)
Tamoxifen
Aromatase inhibitors

Invasive (Surgical)
Oophorectomy

Question 10

Which hormone therapy treatment is effective HER2+ women?

Answer 10

Aromatase Inhibitors) Arimidex, Letrozole, Exemestane

Question 11

Which hormone therapy treatment is effective given after chemo?

Answer 11

tamoxifen

Question 12

Which hormone therapy is effective in all age groups rather than just in post menopausal?

Answer 12

tamoxifen

Question 13

How should benign breast cysts be treated?

Answer 13

aspiration

Question 14

Is risk of developing cancer in patients with cysts considered of clinical significance?

Answer 14

nope

Question 15

Where is cyclical mastalgia?

Answer 15

Classically – outer half of each breast

Question 16

Where is non cyclical mastalgia?

Answer 16

Pain can arise from chest wall, breast or outside breast

Question 17

Which type of mastalgia tends to occur in younger women?

Answer 17

cyclical

Question 18

Treatments for mastalgia?

Answer 18

Evening Primrose Oil
Gamolenic acid 
Danazol  100mg od
Bromocriptine 
Tamoxifen

Question 19

What colour is physiological nipple discharge?

Answer 19

Colour varies from white to yellow to green to blue/black

Question 20

What percent of patients with a bloodstained discharge will have an underlying malignancy?

Answer 20

5-10%

Question 21

What drugs can cause gynaecomastia?

Answer 21

cimetidine, digoxin, spironolactone,androgens, antioestrogens

Question 22

In who is periductal mastitis common?

Answer 22

smoking