Breast Tutorial Flashcards
What are the risk factors for the development of benign breast disease?
Age Female sex Fat necrosis; trauma OCP; fibrocystic change Menstrual abnormalities
What investigations are warranted for a suspected fibroadenoma?
USS with shear wave elastography
Core biopsy
If under 23 with a suspected fibroadenoma on USS: you don’t biopsy in Tayside
What are the differentials for benign breast disease?
Fibroadenoma Cyst Lipoma Abscess Fat necrosis Hamartoma (Radial scar - kind of a premalignant condition)
What is the management for fat necrosis?
Drain
Antibiotics
What is the main piece of advice you can give for fibrocystic disease?
Cease smoking
What is the function of prolactin and oxytocin in breastfeeding?
Prolactin; increases milk production
Oxytocin; smooth muscle contraction via myoepithelial cells for ejaculatory response
Differential diagnosis for an infected looking breast?
Mastitis
Abscess
Engorgement
Inflammatory carcinoma
Criteria for SIRS?
Temp <36 or >38
Tachy >90
Increased WCC or lactate
Tachypnoea >20
What type of gland is the breast?
Apocrine gland
How many lobes are present in each breast?
15-25
What is the main lymph drainage of the breast?
75% to axilla
Internal mammary/ parasternal
Subclavicular
Little bit to baston venous plexus
Can you do a sentinel node biopsy in pregnant women?
No; blue dye is teratogenic
What is the protocol surrounding chemo in pregnancy for breast ca?
Not in 1st trim
Can be given in 2nd trim
Stop 2-3 weeks prior to delivery to avoid neutropenia and therefore infections
Can women who are in remission for breast ca have any form of contraception?
No; can’t have hormonal contraception
But; after 5 years in remission, the risk goes down vastly
What are the rules surrounding getting pregnant after breast cancer?
On tamoxifen for 3 years and therefor need to wait at least as long as that
Need to be off tamoxifen for 3 months prior to conception due to long half life and teratogenicity
