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Breast > Investigations > Flashcards

Investigations Flashcards

1
Q

Staging vs grade? (2)

A
  • Staging: how much has it metastisied

- Grade: how much like a breast cell does it look? The more it does the better

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2
Q

Sentinal node biopsy reason and method (2)

A

Finding node to which the tumour will metastitise first

- Inject blue dye/radioactive isotope traced with gamma camera

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3
Q

What is the rule for cannulations in a patient with an axillary excision?

A

Do in the other arm as impaired drainage

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4
Q

Core needle biopsy method (3)

A
  • Ultrasound guided
  • Large needle guided into lump
  • Small cylinders of tissue (cores) removed
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5
Q

What should anyone with a breast lump should be referred for?

A

Triple assessment

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6
Q

What does triple assessment consist of in breast? (3)

A
  • Examination
  • Radiology
  • Histology/cystology
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7
Q

What radiology technique is best for women above 35 for breast? Why?

A

Mammogram - tissue not dense anymore so tumours show

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8
Q

What radiology technique is best for women under 35 for breast? Why?

A

Ultrasound - young breast tissue too dense to show tumours

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9
Q

Define stage 1 breast cancer

A

Confined to breast, mobile

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10
Q

Define stage 2 breast cancer

A

Confined to breast
Mobile
Lymph nodes in ipsilateral axilla

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11
Q

Define stage 3 breast cancer (3)

A
  • Tumour fixed to muscle (but not chest wall)
  • Ipsilateral lymph nodes matted/fixed
  • Skin involvement more than tumour
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12
Q

Define stage 4 breast cancer

A
  • Complete fixation of tumour to chest wall

- Distant metasteses

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13
Q

Define the T part of the TNM staging of breast cancer

A
  • T1 = less than 2 cm
  • T2= 2-5cm
  • T3 = 5cm+
  • T4=fixation of tumour to chest wall/peau d’orange
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14
Q

How often and what age of women are offered breast screening?

A

3 yearly 50-70 years

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15
Q

What does breast screening involve? (2)

A

2 mammogram views of breast taken - cranio caudal and lateral oblique

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16
Q

Define the NM part of the TNM staging of breast cancer

A

N1: mobile ipsilateral nodes
N2: fixed nodes
M1: distant metasteses

17
Q

What do cells that look more undifferentiated have a higher grade (i.e worse prognosis)? (3)

A
  • Loses differentiated characteristics
  • Cellular machinery increases activity
  • Higher mitotic index
18
Q

Clear excision margin meaning?

A

No cancer cells are seen at the outer edge of the tissue that was removed

19
Q

What type of breast cancer has a better prognosis?

A

Oestrogen positive

20
Q

Indication for wide local excision vs mastectomy (2)

A

Multifocal? Fhx?

21
Q

What is a triple negative cancer? Why does it have a worse prognosis?

A

Does not express genes for

  • Oestrogen receptor (ER)
  • Progesterone receptor (PR)
  • HER 2

(drug therapy targets)

22
Q

Hormone markers measured in breast tumours?

A
  • Oestrogen
  • Progesterone
  • HER 2
23
Q

Oncotype dx indication?

A

Likelihood of breast cancer returning test

Determines need for chemotherapy as added to hormone therapy

24
Q

Oncotype scores meaning

A

Score 0-17: Low recurrence (chemotherapy risks ouweigh benefits)
- Score 18-30: medium recurrence score = uncertain
- Score 31-100: high recurrence score
(chemotherapy benefit worth risk)

25
Q

What are the indications for doing a sentinel node biopsy?

A
  • USS shows positive node involvement

-

26
Q

What do the results of a sentinel node biopsy indicate?

A

Need for axillary clearance vs excision biopsy

27
Q

Fine needle aspiration method

A
  • Repetitive stabbing motions with hollow needle

- Sample sent for cytology (cells)

28
Q

What is a FNA needle sent for?

A

Cytology (cells)

29
Q

What are the 2 methods of histopathology in breast investigation (2)?

A
  • Fine needle aspiration

- Core biopsy

30
Q

What is a core biopsy sent for?

A

Histology

31
Q

NPI - Nottingham Prognostic Index (3)

A
  • Lesion (cm)
  • Number of involved lymph nodes (score: 1-3)
    • Tumour grade
32
Q

What are the contraindications for a sentinel node biopsy? (6)

A
  • If axillary USS showed a malignant node
  • Pregnancy
  • Already metastised
  • Older
  • High BMI
  • Ex lymph node failure

Breast (7 decks)

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