Breast Vivas Flashcards

1
Q

Non modifiable RFs for breast cancer

A

Age
FH
Genetics: BRCA1/ BRCA2
Nulliparity/ not breastfeeding
Early menarche, late menopause
Ionising radiation
Past breast cancer

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2
Q

Modifiable RFs for breast cancer

A

HRT
COCP
Alcohol
Obesity

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3
Q

Most common breast cancer

A

Invasive ductal carcinoma

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4
Q

Screening for breast cancer

A

Every 3y from 50-70
Mammogram

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5
Q

Treatment of breast cancer

A

Wide local excision or mastectomy
+/- Whole breast radiotherapy
+/- Hormone therapy
+/- Biologic therapy

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6
Q

Prior to surgery, what should be performed in women with no palpable axillary lymphadenopathy at presentation?

A

Pre-op axillary US
If -ve: sentinel node biopsy to assess nodal burden

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7
Q

In women with palpable axillary lymphadenopathy at presentation what is indicated?

A

Axillary node clearance at primary surgery

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8
Q

Name 2 complications of axillary node clearance

A

Arm lymphedema
Functional arm impairment

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9
Q

5 indications for mastectomy

A

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

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10
Q

5 indications for wide local excision

A

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

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11
Q

What treatment can be used for oestrogen receptor positive breast cancer?

A

Pre- / perimenopausal: Tamoxifen

Post menopausal: Anastrazole (Aromatase inhibitor)

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12
Q

3 sides effects of Tamoxifen

A

Increased risk endometrial cancer
Increased risk VTE
Menopausal Sx

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13
Q

What biological therapy is used in breast cancer that HER2 positive?

A

Herceptin (Trastuzumab)

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14
Q

Name a contraindication to Trastuzumab

A

Hx of Heart disorders

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15
Q

What tool gives indication of survival in breast cancer?

A

Nottingham Prognostic Index
(Tumour size, LN score, grade score)

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16
Q

Indications for breast 2ww

A

> ,30 + unexplained breast lump +/- pain
OR
,50 + with any of following in 1 nipple only: discharge, retraction/ other changes of concern

17
Q

Indication for non urgent breast referral

A

Age <30 with unexplained breast lump +/- pain

18
Q

What is Paget’s disease of the nipple?

A

Eczematoid change of the nipple a/w an underlying breast malignancy

19
Q

Where does breast cancer commonly metastasise to?

A

Bones
Lungs
Brain
Liver

20
Q

Painful breast ddx

A

Mastitis
Breast abscess
Fibrocystic disease
Duct ectasia

21
Q

Breast mass ddx

A

Fibroadenoma
Fibrocystic disease
Breast cancer
Duct ectasia
Fat necrosis
Breast abscess
Breast cyst

22
Q

Nipple discharge ddx

A

Duct ectasia
Duct papilloma

23
Q

What is a Fibroadenoma?

A

Mobile, firm, smooth breast lump - a ‘breast mouse’

24
Q

Ix for Fibroadenoma

A

Triple assessment

25
Q

Mx of Fibroadenoma

A

> 3cm: surgical excision