Breast Surgery Flashcards
Name the three arteries that supply each breast.
- Internal Mammary (Thoracic) artery/vein
- Intercostal artery/vein
- Axillary artery/vein
Name the most common type of breast cancer.
Infiltrating ductal carcinoma (85-90%)
Why didn’t the radical mastectomies lower the death rate in the past?
Breast cancer may be more of a systemic disease than previously mentioned. Though it may spread first to the axillary nodes, it may bot always do that and may already be in the systemic circulation.
When a pt has a lumpectomy, and the tissue is malignant, what is the next step?
The pt will often have an axillary node dissection INSTEAD of mastectomy. The recurrence/ survival rates will be the same as if she had the much more traumatic mastectomy.
Estrogen promotes the growth of which structure?
Ductal structures
Progesterone promotes the growth of which structure?
Lobular structures
Define the following breast biopsies: Fine needle biopsy, core needle biopsy and open breast biopsy (excisional breast biopsy or lumpectomies)
Fine needle biopsy is done in the Dr’s Office and cells are sent. This is to rule out a breast cyst.
Core needle biopsy requires a local anesthesia in an outpatient setting. Specimen to lab.
Open breast biopsy is done under local or general anesthesia.for comfort of the patient. This procedure can be done for malignant or benign tumors.
Define a FROZEN or QUICK SECTION.
This specimen is sent during the operation. The specimen is sent directly DRY (NO FORMALIN), and in a sterile container to the pathologist. The surgical set up is kept sterile until a report comes back that the specimen biopsy us suitable and the margins for the diagnosis are confirmed.
How will the set up change if there is positive diagnosis from the Quick Section? (Provided that there is consent to move forward)
A separate sterile set of instruments should be used so cancer cells are NOT transferred to health tissue. Breast biopsy instruments separated from those needed for the larger procedure (mastectomy or axillary node dissection.
What type of tray do you need for a breast biopsy?
Name some of the specific instruments you would use.
Minor tray set.
Scalpel, tissue forceps, metz, mayo scissors, ESU, something to grasp the breast lump, hemostats, needle driver, sponges and closing sutures. These instruments can be placed on the mayo table, leaving the remaining instruments clean and NOT contaminated.
True or false: You must change your gloves and gown in order to carry on with the lumpectomy or mastectomy, if needed.
Trick Question - This depends on the hospital policy however, you may be required to change your gown and your gloves OR just your gloves.
For open breast biopsy with wire localization, where is the lump sent to?
The lump and the wire are sent to RADIOLOGY, not pathology. A mammography is performed to check for specimen validity and free margins.
What type of lumps require open breast biopsy with wire localization?
Smaller lumps that were too small to be felt, but were caught on mammography. This is a good sign for the woman.
Define a sentinel node biopsy.
A procedure that predicts how a woman with a positive breast lump will do later. It is the first node in the chain nearest the tumor.
True or False: A woman with a negative sentinel node biopsy does not need an axillary node dissection.
TRUE! Appropriate treatment will follow.
