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breast medicine > Breast OSCE Stuff > Flashcards

Breast OSCE Stuff Flashcards

1
Q

Does the risk of breast cancer increase or decrease, as you get older?

A

Increase

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2
Q

What is the lifetime risk of breast cancer?

A

1 in 8 women

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3
Q

What are the risk factors of Breast Cancer?

A

Early age of menarche

Late age of Menopause

Contraceptive use

HRT use

Family history of Breast Cancer (1st degree family member)

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4
Q

What are the three components of the Triple Assessment?

A

Clinical Assessment

Imaging Assessment (Ultrasound or Mammogram)

Needle Biopsy

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5
Q

For each stage of the triple assessment, there is a grade that is given to the section depending on the assessment. What are the 5 grades?

A

normal

benign

indeterminate/probably benign

suspicious

malignant

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6
Q

What is involved in the Clinical Assessment section of the triple assessment?

A

Normal patient assessment - taking a clinial history and doing a physical examination.

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7
Q

What is involved in the Imaging Assessment of the triple assessment?

A

The patient would have either an ultrasound scan or a mammogram.

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8
Q

When would you prefer to do an ultrasound scan, compared to a mammogram?

A

Ultrasounds should be done for women younger than 40 years old, as their breasts are denser.

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9
Q

What questions should you ask about for a breast history?

A

Lump: where, when did it start, it it mobile, does it come and go?

Breast pain? - SOCRATES

Nipple discharge - blood, pus, milk etc?

B symptoms - fever, malaise, myalgia, weight loss, night sweats

Lymphadenopathy

Nipple retraction or inversion

Nipple eczema

Change in skin colour

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10
Q

What three positions should you put a woman in to do the initial observations of the breast?

A

Stand normally with hands in front of her

Stand with hands above their head

Stand with hands on their hips

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11
Q

Which part of the breast system must you NOT forget to examine?

A

The axillary component

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12
Q

What are the two views that are carried out in mammography?

A

Mediolateral oblique (MLO) view

Craniocaudal (CC) view

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13
Q

What view of the breast is this?

A

Mediolateral oblique

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14
Q

What view of the breast is this?

A

Caudaocranial view

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15
Q

What does a hypoechoic mass show in ultrasound of the breast?

A

This shows a cyst or abscess

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16
Q

What does a poor-dermacated mass show in an ultrasound of the breast?

A

This shows a fixed mass which is most likely due to a malignancy.

17
Q

What is the best imaging test for breast pathologies?

A

Magnetic Resonance Imaging

18
Q

When and why is Fine Needle Aspiration used?

A

Fine Needle Aspiration is used when a lump is suspicious. It is used to determine whether there are malignant cells within the mass.

19
Q

Why would you do Core Needle Biopsy?

A

Core needle biopsy is the best way to determine the grade and type of a breast cancer a person has.

You can determine how differentiated the cells are and which receptors they have on the cells in order to develop a management plan.

20
Q

What is sentinel node biopsy?

A

This is done when a breast cancer has been identified, and it helps to determine which lymph node is most likely to be affected if there is metastasis. This is a good method of assessment as it allows for assessment of metastasis without causing extensive lymphoedema.

21
Q

What is x?

A

Suspensory ligament

(Cooper’s Ligament)

22
Q

What is x?

A

Lobe

23
Q

What are the two labels at x?

A

Lacteriferous sinus and Lactiferous duct

24
Q

In which quadrant of the breast do most breast cancers occur?

A

Upper outer quadrant

25
Q

What are the different property sections that need to be identified for a mass to be deemed malignant or suspicious?

A

Consistency - nodular or smooth

Mobile or Fixed

Irregular/regular margins

Size - big or small

Location

Associated symptoms - discharge, pain, nipple dysmorphia

26
Q

What is the grade of a breast cancer?

A

It represents the aggressive potential of the cancer.

To determine the grade of a cancer, pathologists take three factors into consideration:

  1. The amount of gland formation (differentiation, or how well the tumour cells recreate normal glands) - scored as 1 above
  2. The nuclear features (pleomorphism, or how abnormal the tumour cells look) - scored as 1 above
  3. The mitotic activity (how much the tumour cells are dividing) - scored as 1 above

Grade 1 breast cancers are slower growing and have a better prognosis. Grade 3 breast cancers are faster growing and are more likely to recur after treatment, so they are associated with a worse prognosis.

27
Q

What is an anti-HER2 therapy that is common in Breast Cancer therapy?

A

Trastuzumab (Herceptin)

28
Q

What does Triple Negative mean?

A

Negative for ER, PR and HER2

29
Q

Which online tool is used to determine the prognostic status of breast cancer?

A

PREDICT

https://breast.predict.nhs.uk/predict_v2.0.html

30
Q

Other than mastitis and breast abscess, what other differential should you be considering in a painful breast that is erythematous?

A

Inflammatory breast cancer

This is a rapily progressing breast cancer with a poor prognosis.

31
Q

What is cyclical breast pain?

A

Breast pain that is associated with periods

32
Q

In mammography, what is popcorn calcification showing?

A

Fibroadenoma

breast medicine (2 decks)

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