Breast Surgery Flashcards
What are the 2 main groups of breast surgery?
Breast-conserving surgery
Mastectomy (removal of all breast tissue)
What procedure(s) come under breast-conserving therapy?
Wide local excision (lumpectomy)
Wire-guided local excision for impalpable disease
Therapeutic mammoplasty
What procedure(s) come under mastectomy?
Traditional transverse mastectomy
Skin-sparing mastectomy with reconstruction
Under what conditions does breast-conserving surgery have the same survival as mastectomy?
Clear 1mm (or higher) margins Neoadjuvant radiotherapy given
What is oncoplastic surgery?
Surgery avoiding tissue deformity by reshaping contours at time of resection
List all the reconstruction options following a mastectomy
External prosthesis
Implant (implant-based)
Flap (autologous)
What are the treatment options for the axilla?
Sentinel node biopsy
Axillary clearance
Axillary radiotherapy
List the options for neoadjuvant therapy
Chemotherapy +/- herceptin
Endocrine (AI for post-menopausal, tamoxifen)
How is response to neo-adjuvant therapy assessed?
Mammogram
US
MRI
What procedure(s) are done for pre-operative axillary staging?
USS axilla (only helpful if +, picks up 50% nodes) US-guided core biopsy
Outline the process of two-stage implant reconstruction
Mastectomy + expander into submuscular pocket
Exchange expander for permanent implant
List the main problems associated with implants
Loss of implants (infection)
Capsular contracture
Implant nippling
Implant migration
What is removed and left in modified radical mastectomy?
Whole breast, skin and axillary lymph nodes removed
Pectoralis major left
When can breast reconstruction be carried out?
Immediately (during mastectomy operation) or delayed until afterwards
What is a flap in breast reconstruction?
Taking skin from another part of the body with its blood supply and using it to reconstruct a breast
