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2b > Breast Examination > Flashcards

Breast Examination Flashcards

1
Q

Average age of breast cancer

A

62

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2
Q

What proportion of women get breast cancer

A

1/8

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3
Q

Why is breast cancer incidence increasing

A
  • increasing age

- increased sensitivity of mammogram screening

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4
Q

Why is breast cancer mortality reducing

A
  • earlier recognition

- tamoxifen

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5
Q

4 presentations of breast cancer

A
  • asymptomatic
  • early symptomatic breast cancer
  • locally advanced breast cancer
  • metastatic
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6
Q

Mainstays of breast cancer diagnosis

A 
Clinical examination
Mammography
Ultrasound
Biopsy
Staging
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7
Q

Presenting symptoms of breast cancer

A 
Painless lump
Nipple discharge
Nipple in drawing
Distortion
Pagets disease
Axillary nodes
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8
Q

Presenting signs of breast cancer

A

Painless lump
Skin tethering
Indrawn nippling

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9
Q

Breast history: presenting complaint

A
  • how long has lump been there
  • tender?
  • cylical (with period)
  • pregnant/breast feeding?
  • size increasing
  • nipple discharge/bleeding
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10
Q

What is the classic feel of a breast cancer lump

A

irregular, hard, fixed

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11
Q

Breast history: general factors

A

Use of oestrogens
General health
Drug history
FHx (and ages)

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12
Q

What does a tender lump at different time of the month suggest

A

Benign

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13
Q

Which diseases are BRCA gene associated

A

Prostate, ovary and breast

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14
Q

What is peau d’orange

A

Skin resembles orange peel as it is oedematous.

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15
Q

What are the two options for breast cancer surgery

A

Masectomy

*Lumpectomy and radiotherapy

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16
Q

Lung mets presentation

A

Cough
Haemoptysis
SOB

17
Q

What can a pleuritic metastasis result in

A

Pleural effusion

18
Q

How to prepare for the breast examination

A

Introduce, identify
CHAPERONE
Clean your hands
Patient to be undressed to waist

19
Q

Breast examination steps

A 
Patient sits on couch facing you
Observe the breast
Look
Lift arms above head
Look
Ask woman to put her arms on her hips and push in
Look
Feel
20
Q

What are you looking for in a breast examination

A

Assymetry
Skin tethering
Nipple retraction
Discolouration

21
Q

How do you feel in a breast exam

A

Press breast vertically down onto ribs
Be thorough through quadrants
Watch facial reactions
Arms raised helps

22
Q

What to do if you find a lump

A 
Size
Mobility
Site and proximity to nipple
Symmetry
Skin tethering
Consistency
Smooth or irregular surface
23
Q

How does benign feel

A

Rubbery

24
Q

How does aggressive feel

A

Hard

25
Q

What if its a triple negative

A

Be careful as this can resemble fibroadenoma

26
Q

What if they are complaining of discharge

A

Ask them to produce some

27
Q

Examination of the axilar

A

Feel behind pectoral muscle

Feel in front of the lattisimus dorsi

28
Q

Which structures is in improtant to preserve in the axilar

A

Long thoracic nerve of bell and thoracodorsal pedicle

29
Q

What are the levels of the axillary nodes catergorised by

A

Relation to pectoralis minor
1- lateral
2-under
3-medial

30
Q

Where else apart from the axilla should you investigate in a breast exam

A

Supraclavicular fossa

31
Q

Metastatic breast cancer survey

A

Liver, lung bases for effusions and spine for tenderness

32
Q

How to finish a breast exam

A

Thank
Sit up and dressed
Explain findings

33
Q

Tests for breast cancer

A

Mammogram and core biospy

34
Q

Breast implants complications

A

Caspule formation, infection, rupture and shape changes with age

35
Q

What is a consequence of removing all the axillary lymp

A

Lymphoedema

36
Q

How do you test if the axilla is involved

A

Sentinel node biopsy

37
Q

Adjuvant therapies for breast cancer

A

Endocrine therapy
Chemotherapy
Radiotherapy
Trastuzumab (Her-2 ab)

38
Q

Endocrine therapies for breast cancer

A 
Tamoxifen
Aromatase inhibitors (anastrozole)
39
Q

Where can skin be moved from to create a new breast

A

Latissimus dorsi
TRAM
Superior gluteal artery perforator flap (SGAP)

2b (28 decks)

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