Breast Surgery Flashcards
Risk Factors for Breast Cancer
Genetics: BRCA1/BRCA2 1st degree premenopausal relative Nulliparity 1st pregnancy >30 years Early menarche/late menopause COCP Obesity
BRCA genes increase risk of which cancers
Breast and Ovarian
Most common type of breast cancer
Invasive ductal carcinoma
What is Paget’s disease of the nipple
Eczematous change of nipple associated with malignancy
How does Paget’s disease in the breast differ from breast eczema
Paget’s disease - eczema primarily involves the nipple
Breast eczema - eczema is more lateral
What is inflammatory breast cancer
Where cancerous cells block the lymph drainage resulting in inflamed appearance of breast
What is triple assessment in breast
Clinical examination
Radiological assessment (mammography, USS)
Biopsy - usually core which allows full histology
What is the 1-5 staging in triple assessment
Exam (P), Imaging (U/M), Biopsy (B). Followed by number: 1 - normal 2 - benign 3 - uncertain 4 - suspicious for malignancy 5 - malignant
Tumour marker for breast cancer
CA 15-3
When would mastectomy be offered over wide local excision in breast cancer surgery?>
Multi focal tumour
Central tumour
Large lesion in small breast
DCIS >4cm
When would a patient undergo axillary node clearance in breast surgery?
If there is palpable axillary lymphadenopathy
If no palpable lymphadenopathy - USS done, if USS positive sentinel node biopsy taken in surgery - if this comes back positive they undergo axillary clearance
Side effects of axillary node clearance
Lymphoedema
Functional arm impairment
What additional treatment can be given to patients who are oestrogen receptor positive
Tamoxifen - in pre menopausal women
Letrozole - in post menopausal women
What extra medication can be given to women who are HER2 receptor Postivie
Herceptin (Trastuzumab)
Breast cancer screening programme
Every 3 years - mammogram
From aged 47-73
