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Breast > Questions > Flashcards

Questions Flashcards

1
Q

What is fibroadenosis

A

Fibrocystic disease (NOT FIBROADENOMA)
Benign mammary dysphasia
Lumpy breasts which may be painful
Symptoms worsen prior to menstruation

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2
Q

What is Paget’s disease of the Breast

A

Eczema like symptoms on nipple and areola
Itchy red rash
Sign of Breast cancer behind the nipple or in Breast tissue elsewhere
Can also get burning sensation and discharge

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3
Q

What is used for er+ Breast cancer in post menopausal women and examples

A

Aromatase inhibitors eg. Exemestane, letrozole and anastrozole

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4
Q

Who can’t trastuzumab be used in

A

Patients with history of heart disorders because side effect is cardiotoxicity

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5
Q

Side effects of tamoxifen

A

Increased risk of endometrial cancer, venous thromboembolism and menopausal symptoms

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6
Q

What is tumour marker for Breast cancer

A

ÇA 15-3

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7
Q

Commonest cause of blood stained discharge in younger women

A

Intraductal papilloma - mass is seldom present

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8
Q

What is the Nottingham prognostic index?

A

Tumour size (x0.2) + lymph node score (0 = 1, 1-3 = 2, more than 3 = 3) + grade score

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9
Q

Interpretation of NPI

A

2-2.4 - 93% 5 year survival
2.5-3.4 - 85%
3.5-5.4 - 70%
>5.4 - 50%

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10
Q

Details of mucinous carcinoma

A

2-3% of all Breast cancers
Grey gelatinous surface macroscopically
Better prognosis
Axillary disease is rare

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11
Q

What is comedo necrosis a feature of

A

High nuclear grade ductal carcinoma in situ

Refers to areas of dead-necrotic Cancer cells - calcification also present

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12
Q

Age of Breast cancer screening

A

50-70
Being expanded to 47-73
Every 3 years
After 70 women encouraged to make own appointments

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13
Q

What is inflammatory Breast cancer

A

Rare but rapidly progressive form of breast cancer caused by obstruction of lymph drainage causing erythema and oedema
Usually primary and is managed with chemotherapy
Dissemination occurs earlier - hence could be signs of secondary mets

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14
Q

Details of ductal carcinoma

A

More likely in post-menopausal women and tends to occur at a single focus within Breast

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15
Q

Details of lobular carcinoma

A

More likely to have multifocal lesions

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16
Q

Size of fibroadenoma which encourages biopsy

A

> 4 cm need core biopsy to exclude phyllodes tumour

17
Q

Details of phyllodes tumour

A

Fast growing to a large palpable firm mass - fibroepithelial - can have benign or malignant potential
Typically occur in women and 15year older average age than fibroadenomas

18
Q

What is mondors disease

A

Superficial thrombophlebitis of the superficial veins of the Breast of chest wall, causes sudden onset pain with swelling and redness - usually linear type lump
Self limiting
Management with NSAIDs

19
Q

When is MRI good for Breast investigation

A

Lobular carcinoma - very sensitive for it in same and contra lateral Breast
Can be good for determining treatment

20
Q

Difference between eczema and Paget’s

A

Eczema typically bilateral and affects the areola first

Paget’s often unilateral and affects nipple first (pruritus might be absent)

21
Q

What type of carcinoma is mucinous

A

Invasive ductal

As is anaplastic

22
Q

What sort of carcinoma is inflammatory

A

ductal

23
Q

Aromatase inhibitors side-effects

A

Joint/muscle ache

Osteoporosis

24
Q

Common neurological side effect from breast surgery

A

Intercosobrachial nerve is commonly sacrificed resulting in an area of numbness on inner, upper arm

25
Q

What is Cowden’s syndrome

A

Multiple hamartoma syndrome - rare autosomal dominant syndrome - multiple non-cancerous tumour-like growths (hamartomas)- found in skin, mucous membranes, thyroid and breast tissue
Hamartomas are benign but people with Cowdens are at increased risk of breast, thyroid, endometrial and kidney cancers
Due to mutations in PTEN tumour suppressor gene

26
Q

What is Li Fraumeni syndrome

A

Mutation in tp53 tumour suppressor gene which leads to susceptibility for multiple cancers - sarcoma, breast, brain and adrenal = 80% of cancers
90% risk of developing an invasive cancer by age 70 and 50% risk by age 30
Also get leukaemia and lymphoma

27
Q

What is Muir Torre syndrome

A

Rare autosomal dominant cancer syndrome - prone to cancer of colon, breast, GU tract and skin
Genes affected = MSH2 and MLH1

28
Q

Two other syndromes associated with increased risk of cancer including breast

A

Ataxia-telagiectasia, Peutz-jaegers

Breast (3 decks)

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