Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Breast > History & Examination > Flashcards

History & Examination Flashcards

1
Q

How common is breast cancer?

A

Most common cancer in UK population

& Most common amongst women globally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is triple assessment?

A

Gold standard practice of assessment of breast symtoms

Clinical assessment + Radiology + Histopathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is triple assessment used?

A

Enables rapid detection of breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What constitutes the clinical assessment

A
  • History
  • Examination of breast & lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is included in the radiological assessment?

A

Mammography

+/- USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is included in the pathological assessment?

A
  • Core biopsy = Use needle to take contents of lesion
  • Fine-needle aspirate cytology (FNAC)
  • VAC-biopsy (similar to FNAC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Difference between core biopsy & FNAC?

A

Core biopsy

  • Looks at tissue so gives tissue diagnosis
  • Can tell difference between CIS & invasive disease

FNAC

  • Can detect presence of malignant cells (cellular diagnosis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What abbreviated terminology can be used to describe breast lesions?

A

1 = Normal breast tissue

2 = Benign

3 = Possible malignant

4 = Likely malignant

5 = Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why are mammograms harder to interpret in younger patients?

A

More fatty tissue in breast of younger patient so can lead to false shadowing on imagine - MORE FALSE POSITIVES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a con of using USS?

A

You have to be present to know where an image was taken anatomically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What key features should you elicit from a history?

A
  • History of PCC & onset
    • Lump
    • Pain
    • Discharge
    • Nipple retraction
    • Bleeding
    • Skin changes
    • Swelling / inflammation
  • Recent trauma
  • Age of menarche / menopause
  • Any children? Age when having first child?
  • Systemic symptoms
    • Loss of appetite
    • Weight loss
    • Lethargy
  • FHx
  • Genetics (e.g. BRCA 1/2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would you describe a lump

A
  • Site
    • Upper/Lower
    • Outer/Inner
    • Central
    • Midline
    • Axial
  • Size
  • Shape - Round / Oval / Irregular
  • Margins - Sharp / ill-defined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give some different nipple changes

A
  • Retraction
  • Eczema vs Paget’s
    • Paget’s can be sign of underlying malignancy
  • Cracked nipple
    • Can occur in breastfeeding
  • Discharge - Clear, blood-stained, black/green, milk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are different types of nipple retraction?

A
  • Slit-like retraction
    • Can be sign of duct ectalasia
  • Circumferential retraction (More concerning)

Important to know if it’s new or longstanding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Whare different skin changes?

A
  • Skin dimpling
  • Peau d’orange
    • Skin lymph expands due to direct invasion into lymphatics or indirect lymphatic compromisation
  • Puckering
  • Rash / redness
17
Q

How do you inspect the breast?

A
  • Inspect
    • Scars, visibles masses, skin changes, nipple changes, etc
  • Ask patients to put hands on hips
    • Does mass move with contraction of pectoralis?
  • Ask patient to put hands behind head
18
Q

How do you palpate the breast?

A
  • Patient lying down, hands behind head
  • Use pads of fingers to press breast against chest wall
    • Clock face method
    • Spiral method
    • Make sure to complete exam before examining specific lumps
19
Q

How do you palpate the axillary lymph nodes?

A
  • Ask patient to rest their arm on yours
  • Palpate axilla with other hand
  • Repeat on other side
20
Q

What are the differential diagnoses for patients with breast lump?

A
  • Fibroadenoma
  • Breast cyst
  • Sebaceous cyst
  • Abscess
  • Phyllodes tumour
  • Fat necrosis
  • Fibrocystic change
  • Cancer
21
Q

What are the features of fibroadenoma?

A
  • Benign, may recur
  • Mobile
  • Smooth
  • More prevalent in young population
  • Resection doesn’t necessarily relieve pain
22
Q

What are the typical features of a breast cyst?

A
  • Benign
  • Disteended, involuted lobules
  • Oval/round, smooth, fluid filled
  • Can be painful or visible
23
Q

What do you do if you drain a breast cyst yet the lump still remains?

A

Give triple assessment

24
Q

What are the features of sebaceous cysts?

A
  • Confined to skin and subcut tissue
  • Can become infected / painful
  • Can visualise punctum (small hole in middle)
25
Q

What are the typical features of a breast abscess?

A
  • Typically secondary to mastitis, so more common in breastfeeding
  • Swollen, tender, red breast +/- systemic symptoms
  • Foul-smelling +/- leakage of pus
  • Can develop very quickly
  • Risk factors
    • Diabetes
    • Smoking
    • Piercing
26
Q

What are the features of a Phyllodes tumour?

A
  • Large
  • Benign, borderline malignant
27
Q

What are the typical features of fibrocystic change?

A
  • Thickening of breast tissue
  • Feels firm, ropey
  • May be associated with pain
  • Usually occurs in pre-menopausal women.
28
Q

What are the typical features of fat necrosis?

A
  • Older/middle aged women
  • History of trauma to breast
  • Palpable lump of damage/ischaemic tissue
29
Q

Good books

A

ABC of breast disease

Teach me anatomy

Teach me surgery

Breast (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions