Breast screening Flashcards

1
Q

When are women screened for breast cancer

A

Offered every 3 years between 50 and 70
Can request over 70

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2
Q

What have to do with breast in mammogram

A

Compress - spread breast tissue in order to visualise

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3
Q

Results from mammogram

A

Routine recall
Technical recall - if not clear enough image
Assessment clinic

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3
Q

Results from mammogram

A

Routine recall
Technical recall - if not clear enough image
Assessment clinic

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4
Q

Assessment clinic

A

Further imaging+/- biopsy, magnification views - calcium, Tomo
Clinical examination
Ultrasound - benign or malignant
Cyst aspiration
Core biospy solid lesions/sus findings

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5
Q

Advantages breast screening

A

Reassurance
Early detection, diagnosis and intervention
Increased prognosis
Less radical treatment and more options
Improved breast awareness

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6
Q

Disadvantages breast screening

A

Radiation from mammogram

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6
Q

Disadvantages breast screening

A

Radiation from mammogram
Anxiety
Discomfort during mammogram
Can miss cancers
Over-diagnosis/treatment

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7
Q

What is a mammogram

A

X-ray

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8
Q

What is high risk screening programme

A

Annual screening programme
If have BRAC1/BRAC2 gene, have mammogram and MRI every year
Radiation therapy -> annual screening aswell

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9
Q

When does GP refer to symptomatic clinic

A

Breast lump
Lump in axilla
Nipple discharge
Pain
Puckering
Abscess - pp/smoking
Trauma
Shape/size
Sebaceous cyst
Implant rupture/change/shifted
CT - incidental finding

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10
Q

Breast symptoms

A

Indentation
Redness/heat
Skin erodion
Asymmetry
Nipple retraction
Oaeu de oramge

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11
Q

What is triple assessment

A

Mammogram >40
US +/- core biopsy
Clinical examintation

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12
Q

What do under 40 and why with symtpomatic

A

US only, no mammogram - dense breast tissue, less risk from radiation expsoeure

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13
Q

Where do US in breast

A

Quadrant that symptoms are in

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14
Q

US benigin tumour

A

Well defined, encapsulated, wider than taller, homgenous, hyperchoic, anechoic (black itself), acoustic enhancements - whiteness at back - accelerated by fluid so faster behind it

15
Q

US malignant tumour

A

Ill defined, irregular, taller than wider, heterogenous, hypoechoic, acoustic shadowing, disrupting breast tissue, acoustic shadowing

16
Q

Palpating benign lump

A

Firm/rubbery, painful, regular, smooth, mobile, no skin dimpling, green and yellow, milky, clear discharge, no nipple retraction

17
Q

Palpating malignatn lump

A

Hard, painless, irregular, fixed to skin/chest wall, skin dimpling, bloody discharge/unilateral discharge, nipple retraction

18
Q

Differentiate between lumps in men on US

A

Behind nipple often gynaecomastia
breast cancer - away from nipple, irregular
Lipomas - rubbery away from nipple

19
Q

How do implants complicate mammograms

A

Implant hides breast tissue
Minimal compression
Breast reduction can also disrupt lines of normal breast tissue

20
Q

Why is there a risk of breast cancer in males but not if had masectomy

A

Men still have some breast tissue
If have masectomy - no breast tissue left

21
Q

Why are lobular cancers more dangerous

A

Easier to miss
Increased chacnes multifocal and bilateral
More difficult to excise with clear margin
More chance masectomy
Always go on to investigate with MRI

22
Q

Why are lobular cancers more dangerous

A

Easier to miss
Increased chacnes multifocal and bilateral
More difficult to excise with clear margin
More chance masectomy
Always go on to investigate with MRI

23
Q

Microcalcifications - malignant or benign

A

Benign - teacupping
Popcorn - calcified fibroadenomas
DCIS - dont leave duct - Intracellular
See on X ray not US
Stereo biopsy on X ray

24
Q

Areas score on breast cancer

A

Examination P1-5
Imaging - M1-5, U1-5
Histology score - H1-5
1 is normal

25
Q

Managment of breast cancer after biopsy

A

Definitive diagnosis
Durther imaging/biopsies
-Treatment plan
Masectomy/WLE

26
Q

Treatment options

A

RR, benign, surgery, WLE (breast conservatiion surgery)/masectomy
Neo-adjuvant chemo
Seed guidede wide locla excision
Radio
Oestrogen blockade

27
Q

What is radio iodine seed used for

A

Mark where cancer is in breast using X ray in advance to surgery
Geiger counter picks up where it is in breast for surgeon
Increased surgical accuracu

28
Q

How big margin of cancer free tissue around cancer excision

A

5mm

29
Q

Indications for MRI

A

Dense breast tissue
Lobular carcinoma, extensive DCIS
malignant axillary lymph nodes but no tumour
Pre and post chemo response
High risk annual screening - BRAC1