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Surgery > Breast > Flashcards

Breast Flashcards

1
Q

What is included in Triple assessment?

A

Imaging (mammography and US)
Clinical examination
Image guided needle biopsy for histology

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2
Q

What is associated with green/brown nipple discharge?

A

Duct ectasia

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3
Q

What is the treatment of choice for duct ectasia?

A

Doesn’t require treatment unless bothering patient
Microdichectomy in younger women
Total duct excision in older

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4
Q

When should mastitis be treated with antibiotics?

A

If systemically unwell
If nipple fissure present
If no symptom relief after 12-24 hours of effective milk removal
If culture shows infection

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5
Q

What is referred to as breast mice?

A

Fibroadenoma

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6
Q

What is the condition? - lumpy breasts in a middle aged women that can be painful. Symptoms typically worsen before menstruation.

A

Fibroadenosis (fibrocystic disease, benign mammary dysplasia)

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7
Q

What can present with blood stained nipple discharge?

A

Duct papilloma

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8
Q

What is associated with axillary node clearence?

A

Arm lymphedema and functional arm impairment

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9
Q

If there is no palpable axillary lymphadenopathy, what should be done prior to breast surgery?

A

US - if US confirms presence of lymphadenopathy then sentinel node biopsy

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10
Q

If a patient has palpable lymphadenopathy, what is indicated?

A

Axillary node clearence

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11
Q

When might a mastectomy be carried out? (4)

A

Multifocal tumour
Central tumour
Large lesion in a small breast
DCIS > 4cm

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12
Q

When might a wide local excision be favoured? (4)

A

Solitary lesion
Peripheral tumour
Small lesion in a large breast
DCIS < 4cm

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13
Q

When might radiotherapy be offered?

A

Following wide local excision - can reduce risk of recurrence by 2/3

Following mastectomy for T3/T4 tumours and for those with 4 or more positive axillary nodes

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14
Q

What hormonal therapy is used in pre- and peri-menopausal women?

A

Tamoxifen

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15
Q

What are the side effects of Tamoxifen?

A

Increased risk of endometrial cancer, VTE, menopausal symptoms

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16
Q

What hormonal therapy is used in post-menopausal women?

A

Aromatase inhibitors - e.g. ANASTOZOLE

17
Q

What is the main side effects of aromatase inhibitors?

A

Osteoporosis

18
Q

Why are aromatase inhibitors preferred in post-menopausal women?

A

Aromatisation accounts for a majority of oestrogen production in post-menopausal women therefore aromatase inhibitors are used

19
Q

What biological therapy is used in tumours that are HER2 +ve?

A

Trastuzumab (Herceptin)

20
Q

In what group of patients is trastuzumab not suitable?

A

Those with a Hx of heart problems

Surgery (8 decks)

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