Breast Surgery

Question 1

Nerve supply for Latissimus dorsi

Answer 1

Thoracodorsal nerve

Question 2

Nerve supply for serratus anterior

Answer 2

Long Thoracic nerve

Question 3

Nerve supply for pectoralis minor

Answer 3

Medial pectoral nerve

Question 4

Branches of the axillary artery from part 1 - 3

Answer 4

Part 1: Superior thoracic A.
Part 2: Thoracoacromial A.
Lateral Thoracic A.
Part 3: Subcapsular A.
Anterior circumflex humeral A.
Posterior circumflex humeral A.

Question 5

TNM stage of breast Ca

Answer 5

T1 : Tumour size <2cm
T2 : 2-5cm
T3: >5cm
T4: any size invading chest wall and/or skin

N1 : 1-3 node +ve
N2: 4-9 axillary nodes +ve, or any apparent internal mammary node involvement
N3: >10 axillary nodes, supraclavicular node
M1: distant mets

Question 6

Common regimes of CTx for breast cancer

Answer 6

Taxane
Anthracycline

Question 7

Which CTx is used for breast cancer with >T1c + HER+ve disease?

Answer 7

Trastuzumab

Question 8

Duration of the Trastsuzumab and follow up regime

Answer 8

every 3 weeks for 1 year
Cardio toxic : Cardiac function assessment every 3 months during the treatment, Every 6 months for 24 months after the treatment

Question 9

Common neoadjuvant regime for triple negative disease

Answer 9

Platinum
Anthracycline

Question 10

What CTx can be added for advanced or metastatic breast cancer who have failed to respond to anti-HER treatment

Answer 10

Tucatinib

Question 11

CTx agents used for breast ca with ER+ve/HER2-ve advanced/metastatic disease who were on endocrine therapy previously

Answer 11

Ribociclib
Fulvestrant

Question 12

The usual regimen of neo-adjuvant chemo for breast cancer

Answer 12

3 cycles of FEC (Fluorouracil/Epirubicin/Cyclophosphamide) + 3 cycles of Taxane