Breast incorrects Flashcards
78 year old, bilateral leg weakness and back pain
breast surgery 2 years ago
minor fall few days ago
weakness of hip flexion bilaterally
most likely diagnosis?
spinal cord compression
osteoporotic vertebral collapse could be the case but is less likely! as stem clearly states breast cancer and risk of mets
infiltrating ductal carcinoma, er positive, her2 negative
currently on aromatase inhibitor and bisphosphonate
history of HTN, HF and previous stroke, next step in management?
no additional treatment
patient is quite comorbid
A 29 year old woman has a red, hard left breast. She is not lactating. She has
had 2 weeks of treatment with co-amoxiclav with no effect. Her temperature
is 37.5ºC, pulse 80 bpm and BP is 114/80 mmHg.
Arrange fast track breast clinic appointment
suspicion of underlying abscess or breast cancer
A 28-year-old woman presents to her GP with a painless lump in her left breast that she discovered two weeks ago. She has no family history of breast cancer, and she has no significant comorbidities. On clinical examination, the GP palpates a firm, mobile, and well-circumscribed mass in the left breast with no associated skin changes or axillary lymphadenopathy.
What is the most appropriate next step in her management?
Consider non-urgent referral in people aged < 30 years with an unexplained breast lump with or without pain
A 55-year-old lady has undergone a wide local excision and sentinel lymph node biopsy for breast cancer. The histology report shows a completely excised 1.3cm grade 1 invasive ductal carcinoma. The sentinel node contained no evidence of metastatic disease. The tumour is oestrogen receptor negative. What is the next course of action?
Arrange radiotherapy
Whole breast radiotherapy is recommended after a woman has had a wide-local excision as this may reduce the risk of recurrence by around two-thirds
The ‘snowstorm’ sign on ultrasound of axillary lymph nodes indicates?
breast implant rupture
treatment for ER+ve breast cancer?
tamoxifen if pre menopausal
anastrazole if post menopausal
ages and frequency for breast screening in UK?
all women aged 50-70 years (mammogram every 3 years)
most likely side effect of tamoxifen?
VTE
A 55-year-old woman is diagnosed with invasive ductal carcinoma of the left breast. The tumour is HER2-negative and oestrogen-receptor-positive.
She has no palpable axillary lymphadenopathy. A pre-operative axillary ultrasound scan is unremarkable. The patient is scheduled for breast-conserving surgery with adjuvant radiotherapy.
Which option should be added to her treatment plan
Sentinel node biopsy
anastrazole mechanism of action? it is used for POST menopausal ER positive breast cancers
Reducing peripheral synthesis of oestrogen. also letrozole - osteoporosis risk with both R
Explain that family members cannot be used for chaperones and reoffer the patient someone at the practice to chaperone
duct ectasia (creamy nipple discharge) treatment
reassurance
A 48-year-old lady presents with discomfort in the right breast. On examination she has a discrete soft fluctuant area in the upper outer quadrant of her right breast. A mammogram is performed and a ‘halo sign’ is seen by the radiologist.
most likely diagnosis?
breast cyst
An obese woman presents with an irregular lump on the lateral aspect of her right breast associated with skin tethering. Biopsy excludes a malignant cause. most likely cause?
fat necrosis
