Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro > Breast Reconstruction > Flashcards

Breast Reconstruction Flashcards

1
Q

Minimum margin for breast cancer

A

1mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Incidence rates of breast cancer are increasing. T/F?

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the usual neoadjuvant therapy prior to surgery?

A

Chemotherapy or endocrine therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 2 types of mastectomy?

A

Standard AKA Traditional transverse,

Skin sparing with immediate reconstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List 3 types of breast conservation surgery

A

Wide local excision,
Image guided local excision,
Oncoplastic breast conservation inc therapeutic mammoplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Neoadjuvant treatment is often used to try and prevent mastectomy by shrinking cancer. What is the standard treatment when using chemotherapy as adjuvant?

A

Standard FEC and taxane +/- herceptin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is herceptin?

A

Trastuzumab - monoclonal antibody for HER2 positive breast cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neoadjuvant treatment is often used to try and prevent mastectomy by shrinking cancer. What is the standard treatment when using endocrine therapy as adjuvant?

A

Aromatase inhibitors for postmenopausal women!

Tamoxifen for pre or postmenopausal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are aromatase inhibitors not used in premenopausal women?

A

Because they cannot stop aromatase enzyme and production of oestrogen in the ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are 3 factors to consider when choosing between breast conservation surgery or mastectomy?

A

Oncological,
Psychological,
Cosmetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Having a mastectomy improves survival and decreases chances of cancer coming back when compared to breast conservation therapy. T/F?

A

False! Breast conservation is at least as safe and may actually have better outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Breast conservation surgery is an option for what two presentations?

A

When patient presents with lump or when patients cancer was picked up on screening and can be localised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If breast cancer is not palpable, what can be done to localise it?

A

Wire, Clips put in at biopsy -> wire then put in under local anaesthetic to bracket the area of disease if there are multiple,
Magnetic seed, (placed under local near clip)
Radiofrequency marker placed there and use detection probe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is oncoplastic surgery?

A

Safe oncological surgery while avoiding tissue deformity so uses cancer and plastic surgery principles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q 
State which type of oncoplastic breast surgery (simple WLE, volume replacement, therapeutic mastopexy or therapeutic reduction mammaplasty) for each case: 
Small cancer small breast,
Med cancer small breast, 
Med cancer med breast, 
Med cancer large breast,
A

Small cancer small breast -> simple WLE,
Med cancer small breast -> volume replacement,
Med cancer med breast -> therapeutic mastopexy,
Med cancer large breast -> therapeutic reduction mammaplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does therapeutic mastopexy work?

A

When cancer in bottom can do it, is a Breast lift - basically remove volume below

17
Q

What is therapeutic reduction mammoplasty?

A

Cancer on outside in large breasts -> bottom base (pedicle) with nipple kept and tissue up and around triangle at bottom of boob
Basially remove tissue underneath, keep tissue so that you can then pull it around so making boobs smaller so is breast reduction with taking cancer out

18
Q

Describe volume replacement surgery

A

Move tissue from nearby e.g. lateral skin flap below axilla and move it over to replace excised cancerous bit

19
Q

Breast conservation is equivalent to mastectomy in disease free and overall survival as long as treatment is? (3)

A

Clear margins >1mm PLUS breast radiotherapy,
Surgical wide excision aim for 1cm excision at all margins,
Perform full thickness (all the tissue inside) excision at anterior and posterior margins

20
Q

Mastectomy cosmetic options?

A

External prosthesis,
Immediate reconstruction,
Delayed reconstruction

21
Q

What tissues are removed in a radical mastectomy? Used to be used in the past but has bad cosmetic outcome

A

All breast tissue, skin, pec major and minor and nodes all removed so ribs visible underneath

22
Q

List the 7 options for reconstruction

A

Implant only,
Latissimus dorsi pedicled flap +/- implant,
DIEP free flap - deep inferior epigastric artery perforator,
IGAP free flap - inferior gluteal artery perforator,
SGAP free flap - superior gluteal artery perforator,
TUG free flap - transverse upper gracilis,
PAP free flap - profunda artery perforator,
TRAM

23
Q

Implant reconstruction accounts for approx ? Of reconstructions in the UK?

A

1/3

24
Q

Main complications of implant reconstruction? (6)

A

Loss of implants e.g. infection (approx.25%),
Capsular contracture,
Implant rippling,
Implant migration,
40% need more surgery,
Small risk of Anaplastic large cell lymphoma

25
Q

Tissue expander placed where used for what?

A

Placed underneath pec muscle and used to expand tissue gradually to allow skin to grow

26
Q

Prepectoral implants are more commonly used now. Where are these placed and what is used to keep them in place?

A

Placed over the pec major muscle under skin and is covered in mesh to keep it in place

27
Q

Why is T-Dap lat dorsi muscle particularly useful tissue for reconstruction?

A

Blood supply is in axilla and scar can be in bra strap

28
Q

Free flap means what?

A

Blood supply is not local so microsurgery needed to connect vessels

29
Q

Axillary treatment options?

A

Pre-operative axillary staging: USS axilla +/- core biopsy,
Sentinel node biopsy,
Axillary clearance,
Axillary radiotherapy

30
Q

Axillary treatment: every patient with breast cancer undergoes what investigation to check axillary nodes?

A

Axillary node USS

31
Q

Axillary treatment: if axillary nodes suspicious on USS, what investigation is carried out?

A

USS guided biopsy

32
Q

If macrometastasis to axillary nodes found in biopsy, what is carried out?

A

Axillary lymph node clearance

33
Q

If no macrometastases found in axillary node biopsy or no suspicious in USS, what is next step?

A

Sentinel node biopsy always!!

34
Q

Complication of axillary node clearance?

A

Lymphoedema!

35
Q

Why take sentinel node biopsy and how?

A

Staging process for axilla,

Inject tracer in breast near tumour and whichever nodes take tracer then are removed

36
Q

What are sentinel nodes?

A

First node where cancer cells likely to spread from tumour

Repro (49 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions