breasts Flashcards
triple assessment for breast cancer involves
Triple assessment, as the name indicates, includes three modalities, physical examination, imaging (mammography and/or ultrasound), and biopsy (FNAC and core biopsy).
tumoru of T2 what would happen
wide local excision and adjuvant radiotherapy
tumour at T3 or more
mastectomy plus adjuvant
abx of choice for mastitis
flucloxacillin
abx of choice for mastitis
flucloxacillin
difference between mastitis and breast abscess
accumulation of pus within breast - fever and tender fluctuant mass - complication of mastitis - need to drain and oral/IV abx
if mamography comes back abnormal and yeild a degree of suspicion for breast cancer what shoudl you do
core-needle biopsy of the mass
if over 30 with unexplained breast mass what should happen
2ww for triple assessment - ultrasound for young women
Non-urgent referral should be carried out for patients under 30 years old with an unexplained breast mass.
letrozole treats - oestrogen receptor positive what shiudl you measure with this drug
bone mineral denisty due to osteoporosis risk
new expanding lump, non-tender and freely moveable in 49yr old
phyllodes tumour - connective tissue - fast growing
firbo-adenoma - firm non tender mobile 20-30 - slow growing and unliekly to double in 2w
trastuzumab - HER2 receptor positive what shoudl you monitor
cardiac function - cardiotoxicity
anastrozole used when
when tomoixfen
oestrogen receptor postive in post-menopausal women
tamoxifen - ostrogen receptor psotive in pre or peri menopausal
anastrozole used when
when tomoixfen
oestrogen receptor postive in post-menopausal women
tamoxifen - ostrogen receptor psotive in pre or peri menopausal
major risk factor for periductal mastitis
smoking
ultrasound under what age if symtpomatic and if asymtpomati what age due to dense breast tissue
35 and 40
mammogrpahy afterwards
less than 4cm
wide excision of mastecotmy
less than 4cm
wide excision of mastecotmy
A 31 year old woman attends her booking visit at 10 weeks gestation. This is her first pregnancy and other than some morning sickness she has had no vaginal bleeding or other problems so far. The results of her booking bloods come back which show no abnormalities, but her Rhesus status is found to be negative. She is worried that she will need injections.
Which of the following is the most appropriate management?
anit d is given as immunoglobulins at 28weeks with further doses if sensitising event occurs
A 31-year-old woman presents to the GP with a new breast lump. On examination, there is a hard, 2cm lump in the upper outer quadrant of her left breast. It is highly mobile and smooth to the touch. It is not painful, and there are no overlying skin changes.
Which is the most appropriate management?
Urgent referral to the outpatient breast clinic
The likely diagnosis for this patient is a benign fibroadenoma; however, as she is over 30 with a new breast lump, she should be urgently referred to the breast clinic for assessment for triple assessment.
blood stained discharge
Intraductal papilloma
high risk of breast cancer criteria
Breast cancer in a first-degree male relative of any age
Breast cancer in a first-degree relative under the age of 40
Bilateral breast cancer in a first-degree relative under the age of 50
Breast cancer in two first-degree relatives
what can occur after infective puerperal mastitis.is treated
candida of the nipple
swelling of arm after a breast surgery 4 years ago what we thinking
This patient has had breast surgery, which is a major risk factor for developing lymphoedema, which can occur months to years after surgery. It is more common in patients who have also undergone axillary node clearance.
axillary node clearance can injure what
Lymphoedema
Damage to brachial plexus
Axillary artery/vein injury
can mammography distinguish between cancer and fat necrosis
no so need triple assessment
differnence between urgent and routine referral to the breast clinic
This patient presents with symptoms of a benign fibroadenoma. For patients under 30, a routine referral to the breast clinic for further assessment or imaging is indicated. If the patient is over 30, this should be an urgent referral.
Patients considered high familial risk should also be referred for urgent assessment. The criteria for this include:
Breast cancer in a first-degree male relative of any age
Breast cancer in a first-degree relative under 40
Bilateral breast cancer in a first-degree relative under 50
Breast cancer in two first-degree relatives
As this patient is under 30, and her mother was over 40 when diagnosed, a routine referral would be indicated for this patient.
what is a galactocele
A galactocele is a breast lesion most commonly occurring in women who have recently ceased breastfeeding. Milk builds up and stagnates within the lactiferous ducts, leading to the formation of a mobile, cyst-like lesion which can be tender.
A 33 year old G1P1 comes in for a routine 6 week post-partum check-up after uneventful pregnancy with an uncomplicated vaginal delivery. She reports no problems and is getting on well with the care of the baby. Her examination shows an irregular, firm, and non-tender uterus at about 14 week size. Which of the following is the most likely explanations for this finding?
Fibroids
Fibroids are abnormal growths of tissue occurring in the uterus. They are highly vascular and often cause heavy bleeding. The examination findings are most consistent with uterine fibroids as they cause the uterus to be enlarged, irregular, and firm
What else can be done to aid the effectiveness of McRobert’s manoeuvre?
applying suprapubic pressure
