Lump Flashcards

1
Q

Skin

A

Tethering - lump attached to skin, but can be moved in arc without moving skin (if pulled outside arc, the skin indents)

Fixation - lump cannot be moved without moving skin

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2
Q

Worrying features on ultrasound

A

Irregular shape
Ill-defined margin
Invades across normal tissue planes where benign masses tend to push them out of the way

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3
Q

Axillary nodes

A

ASSESSMENT ESSENTIAL - very important prognostic factor

Important for planning management - sentinel node biopsy / axillary node clearance

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4
Q

Sentinel Node Biopsy

A

First lymphatic node to collect cancer - can be one or more found on biopsy

Sentinel node biopsy is a surgical procedure that identifies and removes the sentinel nodes - sent to pathology for analysis and staging of the cancer (results in 1 week)

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5
Q

Ultrasound > stereotactic

A

No ionising radiation involved
The patient is less likely to faint
Biopsy needle can be seen in real time - satisfactory targeting

Local anaesthetic needed for both

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6
Q

Grading - how aggressive the cancer is

A
  1. The amount of gland formation
  2. The nuclear structures
  3. The mitotic features

ER positive? PR positive? HER2 positive?

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7
Q

Tx

A

ER and PR expression - endocrine therapy e.g. tamoxifen

HER2 overexpression - anthracycline and taxane-based chemotherapies and directed therapies that will target HER2 (trastuzamab) but no endocrine based therapies

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8
Q

Types

A

Invasive ductal carcinoma - most common

Invasive lobular carcinoma - second most common. Can be difficult to detect. May present as thickening rather than lump. Patients need MRI.

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9
Q

Fibroadenoma - composed of both stromal and epithelial components

A

Most common benign lump
USS - solid mass, ovoid shape, well-defined margin

*For suspected fibroadenomas in patients under 25 a biopsy need not be performed if the clinical and ultrasound features and benign.

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10
Q

Fibroadenoma tx

A

No tx

Excision if 4cm, growing, patient request

(Generally stay the same size however may change size in teenage girls / pregnancy. Postmenopausal women - ‘popcorn calcification’

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11
Q

Breast Cysts

A

Benign and therefor do not need tx

Aspirate if symptomatic - can be many different colours. If blood stained - cytology.

Cysts do not turn into cancer

Safetynet

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