breast lecture / NICE key points

Question 1

normal hormonal discharge

Answer 1

multiduct
clear
brown
white

Question 2

profuse and white discharge

Answer 2

prolactinoma

Question 3

duct ectasia discharge

Answer 3

multiduct and yellow / white

Question 4

bloody discharge most common

Answer 4

papilloma

Question 5

screening

Answer 5

from 50-70 every 3 years - mammogram

Question 6

when USS axilla

Answer 6

if something worrying in breast on US or mammo
only ipsilateral axilla

Question 7

ix for simple cyst

Answer 7

clinical exam
USS / mammo
no biopsy - unless for sx relief

Question 8

do fibroadenoma get biopsy

Answer 8

no if under 30 and definitely fibro on USS

Question 9

cut off for mammogram

Answer 9

40 yrs

Question 10

breast cancer risk factors

Answer 10

Question 11

most common type of breast cancer

Answer 11

invasive ductal carcinoma (no-special type)

Question 12

nice criteria for referral

Answer 12

Question 13

criteria for mastectomy

Answer 13

Question 14

criteria for wide local excision

Answer 14

Question 15

when is radiotherapy needed

Answer 15

after wide local excision

or mastectomy if T3-T4 tumours

Question 16

when is family hx significant

Answer 16

Age of diagnosis < 40 years
Bilateral breast cancer - first less 50yrs
Male breast cancer
2 first degree / one first and one 2nd degree
Ovarian cancer
one first / second degree relative with ovarian cancer at any age
Jewish ancestry
Sarcoma in a relative younger than age 45 years
Glioma or childhood adrenal cortical carcinomas
Complicated patterns of multiple cancers at a young age
Paternal history of breast cancer (two or more relatives on the father’s side of the family)