Breast reconstruction

Question 1

Clinical features of breast cancer

Answer 1

irregular
ill-defined
firm
fixed
skin involvement
peu d’orange
lymphadenopathy
bloody nipple discharge
asymptomatic if through breast screening program

Question 2

6Ss of lump/bump examination

Answer 2

site
size
shape
surface
substance
surrounding structures

Question 3

How is breast cancer diagnosed?

Answer 3

clinical examination
mammography/ultrasound/(MRI)
fine needle aspiration cytology or core biopsy

Question 4

What is breast cancer triple assessment

Answer 4

examination score
imaging score
histology score

each element scored out of 5
1 = normal
2 = benign
3 = indeterminate probably benign
4 = suspicious of cancer
5 = cancer

Question 5

If breast cancer is diagnosed - what tests should be done?

Answer 5

staging CT
bone scan
sentinel lymph node biopsy

Question 6

What surgeries can be done for breast cancer?

Answer 6

mastectomy
breast conserving surgery (wide local excision)
lymph node surgery (sentinel node biopsy, axillary node clearance)

Question 7

Why do women request breast reconstruction?

Answer 7

loss of femininity
loss of self esteem
loss of self confidence
difficulty in clothing
heavy prosthesis
constant reminder of breast cancer

Question 8

Aims of breast reconstruction surgery

Answer 8

restore breast mound
symmetry of volume and shape
restore nipple areolar complex

Question 9

Advantages and disadvantages of immediate breast reconstruction

Answer 9

advantages:
- better aesthetic result
- can utilise normal breast skin envelope
- patient never without breast mound
- fewer operations

disadvantages:
- rushed decision
- oncological treatment not finalised
- patient less pleased with aesthetic result

Question 10

Advantages and disadvantages of delayed breast reconstruction

Answer 10

advantages:
- longer time to decide on type of reconstruction
- all oncological treatments finished
- better appreciation of results

disadvantages:
- poorer aesthetic result
- more operations
- prosthesis