Breast & Womens Health Flashcards
Features of bloody nipple discharge associated with malignancy
- Spontaneous
- Unilateral
- Localized to a single duct
- Present in women >40 years pf age
- Bloody
- Associated with a mass
Benign milk filled cysts that occur almost exclusively in lactating women characterized by a triad of secretory breast epithelium, prolactin stimulus , and ductal obstruction.
Galactocele
Involves resection of the primary breast cancer with a margin of normal appearing breast tissue, adjuvant radiation therapy, and assessment of regional lymph node status.
Breast conservation therapy
Breast conservation treatment for T2 N0 M0 breast carcinoma must have __________?
Adjuvant radiotherapy
Absolute contraindications to breast conservation surgery?
- Prior radiotherapy
- Pregnancy ( 1st to 2nd trimester)
- Persistently positive margins
- Multicentric lesions
- Diffuse microcalcifications
- Connective tissue disorders
Management of breadt cancer during pregnancy?
1st & 2nd trimester:
1. Modified Radical Mastectomy
3rd trimester
1. Lumpectomy with axillary node dissection ( if adjuvant radiotherapy is deferred until after delivery)
Triad of Carcinoid Syndrome?
Flushing
Diarrhea
Cardiac involvement
Drugs used in the management of Cushings disease?
Aminoglutethimide
Ketoconazole
Metyrapone
Percentage of women with BRCA1 mutation developing breast cancer before age 70.
55-65% of women
Diagnostic features of MEN2B ?
- MTC
- Pheochromocytoma
- Multiple neuromas
- Long narrow face , retrognathia, highly arched palate
- Marfanoid habitus
Reddish tender , warm breast in a nursing mother is most likely a case of?
Epidermic puerperal mastitis
Which of the following is a characteristic of pathologic nipple discharge ?
Spontaneous and non-bloody
Most widely used and accurate modality for preoperative localization of abnormal parathyroid gland is _________.
Technitium -sestamibi scan
Which statement regarding the emissary vein is correct?
It is located in the loose areolar tissue
Lateral border of the breast found at the anterior axillary line
Axillary tail of Spence
_________________ are found deep to the pectoralis minor muscle
Breast lymphatics
Risk factors for Zuka’s disease , also known as recurrent periductal mastitis
Cigarette smoking
Venous plexus that extends from the base of the skull to the sacrum?
Batson vertebral plexus
Provides a route for breast cancer metastasis.
Risk factors for Breast Cancer? (6)
- Increased exposure to estrogen
- Radiation exposure
- Increased alcohol intake
- High fat diet
- Prolonged use of OCPs and HRT
- Family history of breast CA
Age of start annual screening mammogram
40 years old
Age of start of annual screening mammography?
40yo
Most common presentation of breast cancer?
Palpable mass
Most common first site of distant spread?
Bone 51%
Lung 17%
Brain 16%
Liver 6%
Diagnostic used to evaluate dense breasts and for BIRADS 0 mammogram results?
Breast ultrasound
Minimum number of nodes required for adequate staging of breast cancer?
10 nodes
Removal of the entire breast and axillary lymph nodes?
Modified radical mastectomy
Management of breast cancer during 1st and 2nd trimester of pregnancy?
Modified radical mastectomy
Cells found in the epidermis of the nipple that is possible source of Pagets diasease of the nipple?
Toker cells
Most striking and consistent symptom of esophageal rupture.
Pain
Phase of caustic esophageal injury when the esophagus is weakest?
2nd phase (ulceration and granulation)
Which of the following characterizes endometrial hyperplasia?
Caused by estrogen secreting tumors like granulosa cell tumor
Surgery as the primary modality of treatment for cervical cancer is generally recommended for what stage of the disease?
I
Virilizing adrenal tumors secretions
Dehydroepiandrosterone
Androstenedione
Testosterone and Estrogen
Which of the following characterizes endometrial hyperplasia?
Caused by estrogen secreting tumors like granulosa cell tumor
Most common gynecologic cancer
Cervical cancer
Hormone responsible for lobular development of the breast ?
Progesterone
Hormone responsible for ductal development of the breast ?
Estrogen
Hormone regulates release of estrogen and progesterone?
LH/ FSH
High risk BRCA mutation carriers do mammogram , TVS, CA 125 yearly beginning at what age ?
25 yo
Microscopic finding of invasive lobular carcinoma?
Indian file configuration : small cells arranged on single file orientation.
Baseline mammogram starts at what age?
35 yo
Annual mammogram begins at what age?
40 yo
Breast surgery:
Resection of primary breast cancer + Margin of normal appearing breast tissue + Assessment of regional lymph nodes status.
Breast Conservation
Breast surgery:
Resection of Medial/ Lateral Pectoral Nerves + Long Thoracic Nerve+ Thoracodorsal Nerve + Pectoralis Major & Minor + All LN + All Breast.
Radical Mastectomy
Same as Radical Mastectomy except all nerves are spared , level III LN spared , Pectoralis Major is spared.
Modified Radical Mastectomy
Spared in Modified Radical Mastectomy? (3)
- All nerves are spared : Long thoracic, Medial / Lateral Pectoral Nerves, Thoracodorsal Nerve
- Level III LN
- Pectoralis Major
