Endo surgery

Question 1

Mammographic features of breast cancer include:

Answer 1

Ill-defined or spiculated mass
Parenchymal distortion
Overlying skin thickening
Malignant calcifications
Enlarged axillary lymph nodes

Question 2

Ultrasound features of breast cancer include:

Answer 2

Ill-defined, usually hypoechoic mass
Distal acoustic shadowing (caused by sound distortion and diffraction by the tumour)
Surrounding halo – caused by oedema and tumour infiltration
Abnormal axillary nodes

Question 3

histological confirmation of breast cancer

Answer 3

core biopsy/ fine needle aspiration cytology

Question 4

breast cancer initial treatment

Answer 4

surgery

Question 5

in breast ca, Neo-adjuvant chemotherapy may be given for

Answer 5

large cancers (>3cm) to reduce their size prior to surgery with the aim of avoiding mastectomy.

Question 6

What three factors are taken into consideration when planning a woman’s breast ca surgical treatment?

Answer 6

patient choice

Tumour location – If the tumour is situated behind the nipple, mastectomy may be the most appropriate form of surgery as the nipple-areola complex will have to be excised. A central quadrantectomy may be appropriate in some cases. The final cosmetic appearance outcome has to be considered and discussed with the patient.

Tumour size – Size of the tumour in relationship to the size of the breast is important. Breast conservation surgery to remove a 25mm mass in 40D sized breast may be possible but a 25mm mass in a 32A sized breast would not be possible as it would give a poor cosmetic result and the margins may not be clear.

Question 7

clinical and pathological factors may influence the choice of breast conserving surgery or mastectomy:

Answer 7

Incomplete excision margins post initial surgery
Young age
The presence of extensive ductal carcinoma in situ
Size of tumour
Position of tumour

Question 8

he following factors influence the use of chemotherapy in breast ca

Answer 8

Young age (especially less than 60)
Axillary node positivity
A large tumour
Histological features such as Grade 3 and/or lymphovascular invasion
Negative Oestrogen Receptor (ER)

Question 9

…accounts for 85 % of all breast cancers.

Answer 9

Invasive ductal carcinoma

Question 10

Invasive ductal carcinoma usually presents as

Answer 10

a palpable lump or an irregular spiculated soft tissue density on imaging

Question 11

…accounts for 85 % of all breast cancers.

Answer 11

Invasive lobar carcinoma