Chapter 17 Breast Flashcards
Where are the Rotter’s nodes and where are they located?
Interpectoral group, Level II
What is the structure that divides the different level of lymph nodes?
Pectoralis minor
What are the borders of axillary dissection?
Superior: Axillary vein
Medial: Serratus anterior
Posterior: Subscapularis
Lateral: Axillary fat pad
Which nerve is responsible for the sensation of the medial aspect of the arm?
Intercostobrachial nerve
Winged scapula. What nerve?
Long thoracic nerve
Weakness in adduction. What nerve?
Thoracodorsal nerve
Veins involved in Mondor’s disease or string phlebitis?
Lateral thoracic vein
Thoracoepigastric vein
Superficial epigastric vein (less common)
Treatment for Mondor’s disease?
Anti-inflammatory medications
Warm compresses
For 4-6 weeks.
Consider excision if no resolution
What is the Van Nuys scoring system?
Prognostic index for DCIS based on size, margin, class and age.
Excision for scores 4-6
Excision with RT for scores 7-9
Mastectomy for scores 10-12
Patient with LCIS, with a positive margin after excision. What is the plan?
Observe / Surveillance
What is the role of tamoxifen or aromatase inhibitors in the management of DCIS?
Adjuvant tamoxifen is considered for DCIS patients with ER-positive disease.
Atypical ductal hyperplasia vs. DCIS
ADH is similar to low grade DCIS. A lesion is considered ADH if if is up to 3mm in size but DCIS if larger than 3mm. Diagnosis is hard to establish by CNB and many cases will require excision.
