Breast Imaging and Surgery Flashcards
what types of surgery are breast conservative
“Lumpectomy”
Wide local excision
Wire guided local excision
what is required for a breast conservative surgery to be as successful as a mastectomy
Clear margins > 1mm
Breast radiotherapy
what neoadjuvant Tx is used to achieve breast conservation
Chemotherapy (standard FEC100 and taxane) +/- Herceptin
what are the mastectomy options for reconstruction
Implant only (+/- autologous cellular matrix)
Latissimus dorsi (LD) pedicled flap +/- implant
Deep inferior epigastric artery perforator (DIEP) free flap [Transverse rectus abdominus flap]
Inferior gluteal artery perforator (IGAP) free flap
what Ix is done for axially stain
USS axilla +/- core biopsy
Sentinel node biopsy
what is the breast area over
2nd - 6th ribs, midclavicular line
what does the breast over lie
deep pectoral fascia
lower part overlies serratus anterior
what extends towards the axilla from the breast
axillary tail of spence
what cases should be imaged
Lumps Unilateral or blood-stained nipple discharge Skin tethering or dimpling Signs of inflammation Axillary lumps
what cases should not be imaged
pain
tenderness
symmetrical nodularity
why would a PC of pain be imaged
if associated with focal/asymmetrical nodule
» exclude underlying mass
Ix»_space; mammogram or USS or both
what Ix would be done for a mass in the < 40
US
what Ix would be done for a mass in the > 40
1st line = Mammogram
2nd line = USS
what are the two most common views used in a mammogram
Mediolateral oblique (MLO) Craniocaudal (CC)
what view is the best single view
Mediolateral oblique (MLO)
