breast diseases Flashcards

1
Q

how do breast diseases commonly present

A

50% asymptomatic via screening

50% symptomatic (half with a with a lump)

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2
Q

symptoms of breast disease

A
dimpled/depressed skin
visible lump
nipple changes eg inversion 
bloody discharge 
texture change 
colour change
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3
Q

what is triple assessment

A

clinical assessment
imaging
histology

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4
Q

what type of imaging is used

A

mammogram in older women

USS in younger

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5
Q

why is mammogram less effective in younger women

A

denser breast tissue

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6
Q

how do DCIS calcifications appear on mammography

A

pleomorphic casting

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7
Q

how is definitive diagnosis of DCIS established

A

vacuum-assisted core biopsy

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8
Q

LCIS most commonly progresses into which type of cancer

A

ductal

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9
Q

what is the preferred surgical treatment of breast ca

A

breast conserving surgery

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10
Q

what is the normal form of breast conserving surgery

A

wide local excision with or without an oncoplastic procedure to shape breast

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11
Q

what is an essential non-surgical component of breast conserving surgery

A

radiation therapy

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12
Q

what is removed in modified radical mastectomy

A

entire breast including overlying skin and axillary lymph nodes
preservation of pec major

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13
Q

what types of breast reconstruction are possible

A

immediate (during the same operation as mastectomy)

delayed (performed at a later date)

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14
Q

how is the result of non-skin sparing mastectomy reconstruction aesthetically poor

A

often results in prominent scars on new breast and a paddle of skin of a different colour/texture

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15
Q

what are indications for post-mastectomy radiation

A

involvement of three or more nodes

positive surgical margins

tumours larger than 5 cm

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16
Q

what is the most commonly used hormonal therapy

A

tamoxifen (oestrogen receptors)

17
Q

what is trastuzamab

A

recombinant monoclonal antibody which targets HER-2 receptors

18
Q

how do phyllodes tumour differ from fibroadenoma

A

tend to be larger (3-6 cm)

occur in older women (35-35 years)

19
Q

management of phyllodes tumour

A

excision with 1 cm margin

follow up

20
Q

how are cysts diagnosed

A

FNA

21
Q

when should fluid from a cyst be sent for cytology

A

if bloody

22
Q

what is the most common aetiology of spontaneous nipple discharge

A

intraductal papilloma

23
Q

investigations for pathological nipple discharge

A

mammography
ultrasonography
surgical excision of the discharging ducts

24
Q

dry, scaly, eczematous nipple

A

paget’s

25
Q

management of mastitis (lactational)

A

fluclox
examination every 3 days
pump infected breast until mastitis clears

26
Q

wen should antibiotics be started for mastitis

A

signs of fever, erythema, induration, tenderness, swelling

27
Q

management of breast abscess

A

aspiration (diagnostic and therapeutic)
surgical drainage under anaesthesia if not responding to aspiration
antibiotics

28
Q

mastitis that doesn’t respond the antibiotics and seems to be diffuse over the breast is suggestive of

A

inflammatory carcinoma