Breast

Question 1

What is the Assessment approach for breast mass

Answer 1

Triple assessment
PE + Imaging + biopsy “core needle”

❤️❤️ DONT MISS THIS! Dont jump directly to management without biopsy even if diagnosis given ⭐️

Question 2

What is the choice of imaging for breast mass?

Answer 2

<40 or >60 & FHx -ve : US
40-60 or FHx +ve: mammo

dont choose if it says mammo annually it should be mammo now

Question 3

[…] biopsy is preferred for breast,
Only choose […] for cystic lesion

Answer 3

Core needle biopsy
Only choose FNA for cystic lesions

Question 4

Breast mass
Bi-rad 0

Answer 4

undiagnostic
More imaging needed

Question 5

Breast mass
Bi-rad 1

Answer 5

Negative
Annual screening

Question 6

Breast mass
Bi-rad 2

Answer 6

benign
Annual screening

Question 7

Breast mass
Bi-rad 3

Answer 7

probably benign
F/u imaging in 6 months

Question 8

Breast mass
Bi-rad 4

Answer 8

Suspicious
Core biopsy

Question 9

Breast mass
Bi-rad 5

Answer 9

probably malignant
Core biopsy

Question 10

Breast mass
Bi-rad 6

Answer 10

Malignant
Surgical resection

Question 11

Mammography screening
at age […] every […]

Answer 11

40-50 q 1 yr
+50 q 2 yr

Question 12

BRCA positive screening:

Answer 12

1. MRI annual at age 25
2. Mammography annual at age 30
3. Ovarian (pelvic US / CA125) annual at 30

Question 13

Choose […] first in malignant breast cases for staging

Answer 13

CT with contrast

Question 14

Management:
Intraductal hyperplasia

Answer 14

WLE

Question 15

Management:
Fibroadenoma

Answer 15

WLE

Question 16

Management:
Phyllode

Answer 16

Benign: WLE
Malignant / >8x8 : simple mastectomy

Question 17

Management:
Intraductal papilloma

Answer 17

Intraductal excision

Question 18

Management:
Duct ectasia

Answer 18

Intraductal excision

Question 19

Management:
DCIS

Answer 19

Mastectomy with SLNB
Or WLE with radiation

Question 20

Management:
LCIS

Answer 20

Interval screening - close surveillance
LCIS could be bilateral

Question 21

Management:
Paget disease

Answer 21

Mastectomy with SLNB

Question 22

Bloody nipple discharge

Answer 22

Intraductal papilloma

Question 23

Unilateral green discharge, inverted nipple

Answer 23

Duct ectasia

Question 24

Oval shaped, mobile mass, related to menstrual cycle

Answer 24

Fibroadenoma

Question 25

Rapidly growing mass, skin thinning
not related to menstrual cycle

Answer 25

Phyllode

Question 26

At what size phyllode must be treated aggressively with simple mastectomy?

Answer 26

8x8

Question 27

Multiple bilateral small masses, milky discharge, painful

Answer 27

Fibrocystic changes

Question 28

Skin retraction overlying the breast with ecchymosis

Answer 28

Fat cyst/necrosis

Question 29

Non-tender lumps confined to areola

Answer 29

Montgomery follicles

Question 30

Paget triad:

Answer 30

1. Erythematous 💢
2. Pruritis⚡️
3. Nipple destruction 🫓

Unilateral nipple dryness, crust & oozing discharge. US & mammo: normal

Question 31

Management:
Breast Abscess

Answer 31

Aspiration

Question 32

At what cases I+D is necessary for abscess ?

Answer 32

-multiple 💕
-5cm or more 🖐🏻
-thinned, ischemic or necrotic skin 🌚

Question 33

Presence of […] is the most significant risk factor for breast cancer

Answer 33

Atypia

Question 34

Breast feeding, red swelling, tenderness, redness (generalized)
Dx:
Tx:

Answer 34

Mastitis
Antibiotics

Question 35

Breast feeding, mass localized, fluctuation, swollen LN, skin thinning / changes
Dx:
Tx:

Answer 35

Abscess
Aspiration

Question 36

After treatment of breast carcinoma
When can patient get pregnant ?

Answer 36

2 years

Question 37

Patient developed numbness in the inner side of her arm after mastectomy
[…] nerve is likely affected

Answer 37

Intercostal brachial nerve

Question 38

Breast feeding mother with history of mastitis treated with ABx present with non-tender fluctuating breast lump.
Most likely diagnosis : […]

Answer 38

Breast antibioma

Question 39

Mastitis VS Absceas

Answer 39

Diffuse ~ Localized
& abscess more likely to involve LNs