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Repro > Surgery breast cancer > Flashcards

Surgery breast cancer Flashcards

1
Q

For ER positive breast cancer patients. who gets tamoxifen for 5 years? premenopausal or postmenopausal

A

premenopausal

-note postmenopausal we give aromatase inhibitor for 5 years

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2
Q

why does the US have the highest incidence of breast cancer in the world

A

bc of more screening

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3
Q

what kind of family history has the highest risk factor in developing breast cancer

A

Pre-menopause, bilateral breast CA relative

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4
Q

why is it that early menstration and later menopause seems to increase your risk for breast cancer

A

Bc you will have a higher exposure of estrongen through your life time

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5
Q

what risk factor associated with pregancy is their with breast CA

A

later pregnancy or not having children is a risk factor

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6
Q

which one has an increase risk for developing breast CA? Adenosis, cysts, fibroadenoma, fibrosis, mastitis

A

adenosis

-note all the others have no risk for developing breast CA

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7
Q

what lifestyle factor shows an increase risk for breast CA

A

sedatary

-fat people who sit on the couch

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8
Q

women greater than 35 yo w/ no personal hx of breast cancer. estimates 5 year and lifetime risks of breast CA? whats the model called

A

Gail model

  • note its only used for blacks/whites
  • sorry mexicans
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9
Q

what are some limitations to the Gail model

A

1) can not have personal hx of breast CA
2) does not account for first degree relatives with breast CA
3) genetic mutations are not considered

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10
Q

what is the sceening average risk age for people who get a clinical breast exam every 1-3 years

A

20-39 yo

-note 40 and older you need annual breast exam and mammogram

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11
Q

what does the gail score need to be to put you in the above average risk for breast CA

A

gail score of > 1.7%

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12
Q

If her sister developed breast cancer at the age of 40, when should the doc start screening her 25 yo younger sister

A

at age 30

-what he said in class

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13
Q

what usually presents as calcifications in the breast (rarely as palpable mass)

A

ductal carcinoma In situ

-mammograms great for this

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14
Q

what is the tumor grading? tumor is 2cm or less across

A

T1

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15
Q

what is the tumor grading? Tumor is more than 2cm but not more than 5cm across

A

T2

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16
Q

tumor grading? tumor is more than 5cm across

A

T3

17
Q

nodal grading. anything greater then 4 is considered what grade

A

N2

-note N1 is 1 to 3 nodes

18
Q

in nodal staging of breast cancer. what nodes are we generally talking about

A

axillary nodes

19
Q

what are the most common sites of breast cancer metastases

A

bone, lung, brain, liver

20
Q

BIRADS classification of 2 is what

A

benign finding

-like a cyst and fibroma

21
Q

what BIRADS classifications do we need to consider a biopsy

A

4 and 5

22
Q

what BIRADS classification do we do a repeat mammogram in 6 months

A

3

23
Q

what age population do we see benign lesions that present as masses (i.e) fibroadenomas, cysts

A

younger women

-note these are NOT a risk for breast cancer

24
Q

what is some concerning nipple discharge

A

if spontaneous, unilateral, from one duct, serous, serosanguinous, or sanguinous
-note bilateral, non-spontaneous discharge typically has benign etiologies

25
Q

nipple excoriation, scaling, eczema. what should we consider

A

paget’s dz

26
Q

erythema and skin thickening (peau d’orange). what should we be concerned about

A

inflammatory breast cancer

27
Q

what is used as an adjunct to mammography. can distinguish cysts from solid masses and solid masses that suggest that they are benign (fibroadenomas)

A

U/S

28
Q

what diagnostic tool is useful for loco-regional staging

A

U/S

29
Q

what is the common roles for MRI

A

1) screening for BRCA
2) evaluate for rupture of implants
3) evaluate extent of malignancy

30
Q

which excisional biopsy is used to biopsy primary tumors

A

core needle biopsy (note this is most common used)

-note fine needle aspiration is used to evaulate concerning lymph nodes

31
Q

which lymph nodes are the first nodes to receive lymphatic drainage from an area. And are most likely to contain metastases

A

sentinel lymph node

32
Q

what dissection is reserved for those who have positive sentinel lymph nodes

A

axillary dissection

33
Q

which surgery is limited to DCIS? Segmental mastectomy, segmental mastectomy w/ sentinel lymph node biopsy, total mastectomy w/ sentinel lymph node biopsy, segmental mastectomy w/ axillary dissection, modified radical mastectomy

A

segmental mastectomy

34
Q

what surgery is used for amenable invasive cancers? Segmental mastectomy, segmental mastectomy w/ sentinel lymph node biopsy, total mastectomy w/ sentinel lymph node biopsy, segmental mastectomy w/ axillary dissection, modified radical mastectomy

A

segmental mastectomy w/ sentinel lymp node biopsy

35
Q

what surgery is used for multifocal DCIS, invasive cancers? Segmental mastectomy, segmental mastectomy w/ sentinel lymph node biopsy, total mastectomy w/ sentinel lymph node biopsy, segmental mastectomy w/ axillary dissection, modified radical mastectomy

A

total mastectomy w/ sentinel lymph node biopsy

36
Q

what surgery is used for amenable invasive cancer w/ lymph node involvment? Segmental mastectomy, segmental mastectomy w/ sentinel lymph node biopsy, total mastectomy w/ sentinel lymph node biopsy, segmental mastectomy w/ axillary dissection, modified radical mastectomy

A

Segmental mastectomy w/ axillary dissection

37
Q

what surgery is used for invasive cancer w/ lymph node involvment? Segmental mastectomy, segmental mastectomy w/ sentinel lymph node biopsy, total mastectomy w/ sentinel lymph node biopsy, segmental mastectomy w/ axillary dissection, modified radical mastectomy

A

modified radical mastectomy

38
Q

who needs radiation? patients w/ T(?) or N(?) invasive cancer

A

patients w/ T3 or N2 invasive cnacer need chest wall radiation
-note all segmental mastectomies for DCIS and invasive cancer need radiation

39
Q

For ER positive breast cancer patients. who gets tamoxifen for 5 years? premenopausal or postmenopausal

A

premenopausal

-note postmenopausal we give aromatase inhibitor for 5 years

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