Breast Conditions

Question 1

risk factors for breast cancer

Answer 1

female gender
age
genetics
precursor lesions
birth of first child after 30
alcohol
early menarche
PMH or FH
nulliparity
obesity

Question 2

1st and 2nd line investigations of the breast

Answer 2

1. exam +/- MMG +/- USS

2. image guided tissue core-needle biopsy

Question 3

preferred Tx for breast cancer

Answer 3

breast conserving surgery +/- radiation

Question 4

what LNs are removed in a radical mastectomy

Answer 4

axillary

Question 5

what kind of mastectomy is preferred for the patient?

Answer 5

skin sparing mastectomy

Question 6

when is radiation indicated post-mastectomy?

Answer 6

more than 3 nodes involved
positive surgical margins
tumours >5cm

Question 7

what is the only structure preserved in mastectomy?

Answer 7

pec major

Question 8

DCIS is palpable/non palpable

Answer 8

non-palpable

Question 9

presentation of DCIS on MMG

Answer 9

malignant califications

pleomorphic

Question 10

Ix DCIS

Answer 10

vacuum assisted core biopsy

Question 11

invasive lobular carcinoma is difficult to see on examination/imaging T or F

Answer 11

T

Question 12

presentation of ductal carcinoma

Answer 12

stellate solid mass

pleomorphic casting microcalcifications

Question 13

symptoms of breast cancer?

Answer 13

dimpled/depressed skin
visible lump
nipple change eg inversion
bloody discharge
texture change
colour change

Question 14

define ANDI

Answer 14

aberrations in the normal development and involution of the breast

Question 15

give examples of ANDI

Answer 15

cysts
fibroadenomas
papilloma

Question 16

“cauliflower extension from a duct”

Answer 16

papilloma

Question 17

what can papillomas cause?

Answer 17

cancerous cysts

Question 18

presentation of breast papilloma

Answer 18

bloody nipple discharge

Question 19

Tx papilloma

Answer 19

removal

Question 20

most common benign neoplasm of the breast?

Answer 20

fibroadenoma

Question 21

what kind of breast discharge is normal?

Answer 21

white discharge

Question 22

palpable mass in teenage years on breast…

Answer 22

fibroadenoma

Question 23

describe a fibroadenoma on examination

Answer 23

rubbery to firm, mobile, smooth with distinct borders, non tender

Question 24

what cancer tumour can mimic a fibroadenoma? how can you ifferentiate this?

Answer 24

phyllodes tumour

usually in older women, usually increase in size

Question 25

medical term for breast pain?

Answer 25

mastalgia

Question 26

when is cyclic mastalgia worst?

Answer 26

premenstrually

Question 27

describe noncyclic mastalgia?

Answer 27

localsied, persistent, less responsive to treatment than cyclic mastalgia

Question 28

Tx non-cyclic mastalgia?

Answer 28

1. reassurance
2. well fitting bra and exercise
3. evening primrose oil
4. NSAIDs
5. tamoxifen