Surgery Flashcards
How is melanoma classified and what is the major determinant of prognosis?
Breslow thickness (height from granular layer to maximum depth of invasion) Clark's level of invasion (extent of dermal penetration).
Thickness of lesion.
What kind of surgery is used for colorectal cancer?
75% treated with sphincter sparing excision of rectum.
Resect tumour and surrounding normal bowel with lymphatics
Fashion non-leaking anastamosis.
80% colon cancers operable and 95% rectal tumours.
What is the effect of radiotherapy on the treatment of breast cancer?
If you don’t give RT to women with DCIS –> double risk of DCIS recurrence and double risk of progression to invasive cancer.
However RT does not affect mortality
What are the risk factors for relapse in women with DCIS?
MARGINS, young age, RT, undefined biological factors.
What is the sentinel node?
On the lateral side of the breast = first port of call for lymph from tumour (and entire breast).
If removed and found not to contain cancer cells, no further surgery required.
What is characteristic of breast cancer in older women and what have tamoxifen trials shown?
Hormonally sensitive.
Look for series of drugs to block oestrogen receptors.
80% of women who were 70+ relapsed with tamoxifen treatment alone.
What are the criteria for having mastectomy?
Choice, multi centric DCIS, invasive cancer in patients refusing neoadjuvant therapies to shrink size of tumour, relapse after breast conserving therapy, prophylaxis.
