Breast Surgery Flashcards

0
Q

What are the most common breast masses?

A

50 infiltrating ductal carcinoma

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1
Q

How do you manage a breast mass on exam?

A

First, get mammogram to characterize mass and rule out other masses–> get core needle biopsy –> excisional biopsy if needle inadequate

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2
Q

What is a fibroadenoma?

A

Firm, mobile,rubbery mass in young women
dx FNA and U/S
tx is elective removal

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3
Q

What is a phyllodes tumor?

A

Huge, benign tumors that distort the breast
dx core or incisional biopsy since FNA is insufficient
tx excision with negative margins

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4
Q

What is a fibrocystic change?

A

Multiple, bilateral lumps that vary with the menstrual cycle; if dominant or persistent lump –> aspiration –> excisional biopsy if mass recurs or persists

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5
Q

How do you treat sclerosing adenosis?

A

Tx careful observation or prophylactic bilateral simple mastectomy; not precancerous, but is a risk factor for cancer

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6
Q

How do you treat atypical ductal hyperplasia?

A

Tx is excision, not precancerous, but high risk of becoming cancer

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7
Q

What is an intraductal papilloma?

A

Presents as bloody nipple discharge; tx galactogram/ductogram-guided excision

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8
Q

What is acute mastitis?

A

breastfeeding women get staph/strep infection through cracks in nipple with yellowish discharge, tx antibiotics and warm compresses, may develop into breast abscess

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9
Q

What is dystrophic calcification?

A

Presents as breast lump following trauma, but work up as a cancer until proven otherwise

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10
Q

What are some of the breast cancer buzzwords?

A

family history, ill-defined or fixed mass, skin or nipple retraction, peau d’orange, nipple eczema, and palpable axillary node

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11
Q

How do you treat breast cancer? What about DCIS and LCIS?

A

Depends on stage
if axillary LN involvement, tx chemo if pre-menopausal, tamoxifen if post-menopausal
chemo in pregnancy if stage III or IV
DCIS: simple mastectomy
LCIS: careful observation or prophylactic bilateral simple mastectomy; not precancerous, but is a risk factor of breast cancers

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12
Q

What is Paget’s disease?

A

presents as “crusty” nipple eczema, indicates underlying infiltrating ductal carcinoma

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13
Q

Where are the common metastasis sites for breast cancer?

A

Bone, liver, brain

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