breast surgery Flashcards
Drugs used in ER +ve cancer
Pre/peri menopausal - tamoxifen SERM
post- aromatase inhibitor (anastrazole)
duct ectasia cause and presentation
normal (25%) involution during period, ducts become shorter
thick green discharge from multiple ducts
single duct discharge- clear with small amount of blood
intra ductal papilloma
periductal mastitis: risk factor and treatment
smoking, coamoxyclav
treatment after a wide local excision
radiotherapy (reduces recurrence)
itchyness of nipple spreading to areola
pagets disease of nipple (urgent referral)
snow storm sign on breast and axilla USS
implant rupture (drainage of silicone)
obese woman presents with an irregular lump on the lateral aspect of her right breast associated with skin tethering. Biopsy excludes a malignant caus
fat necrosis
More common in obese women with large breasts
May follow trivial or unnoticed trauma
Initial inflammatory response, the lesion is typical firm and round but may develop into a hard, irregular breast lump
Rare and may mimic breast cancer so further investigation is always warranted
T staging for breast cancer
T1 <2cm, T2 2-5cm, T3 5+cm, T4a invades chest wall, T4b invades skin (includes ulceration or oedema), T4c invades chest wall and skin, T4d inflammatory breast cancer.
when to excise fibroadenoma
> 3 cm
Comedo necrosis
feature of high nuclear grade ductal carcinoma in situ. It is has a high risk of being associated with foci of invasion.
most common breast cancer
Invasive ductal carcinoma (no special type)
halo sign
breast cyst
lumpy sometime painful breasts, sx worse before menstruation
fibroadenosis
mastectomy
vs
Wide local excision
Multifocal tumour Solitary lesion
Central tumour Peripheral tumour
Large lesion in small breast Small lesion in large breast
DCIS > 4cm DCIS < 4cm
