Breast PM Flashcards
A 74-year-old woman presents with a breast lump. On examination, it has a soft consistency. The lump is removed and sliced apart. Macroscopically there is a grey, gelatinous surface.
A. Eczema of the nipple
B. Ductal carcinoma in situ
C. Mucinous carcinoma
D. Invasive ductal carcinoma
E. Invasive lobular carcinoma
A 74-year-old woman presents with a breast lump. On examination, it has a soft consistency. The lump is removed and sliced apart. Macroscopically there is a grey, gelatinous surface.
A. Eczema of the nipple
B. Ductal carcinoma in situ
C. Mucinous carcinoma
D. Invasive ductal carcinoma
E. Invasive lobular carcinoma
Mucinous carcinomas comprise 2-3% of all breast cancers. They are one of the special type of carcinomas. These have a better prognosis that tumours of Non Special Type (NST) and axillary nodal disease is rare in this group.
Comedo necrosis is a feature of high nuclear grade ductal carcinoma in situ. It is has a high risk of being associated with foci of invasion.
What causes comedo necrosis?
Mucinous carcinoma
Invasive ductal carcinoma
Invasive lobular carcinoma
Paget’s disease of the nipple
Lobular carcinoma in situ.
Comedo necrosis is a feature of high nuclear grade ductal carcinoma in situ. It is has a high risk of being associated with foci of invasion.
What causes comedo necrosis?
Ductal carcinoma in situ
Invasive ductal carcinoma
Invasive lobular carcinoma
Paget’s disease of the nipple
Lobular carcinoma in situ.
The combination of a grade 3 tumour and axillary nodal metastasis in a young female would attract a recommendation for what therapy?
Cytotoxic chemotherapy
Radiotherapy
Endocrine therapy using letrozole
Endocrine therapy using tamoxifen
The combination of a grade 3 tumour and axillary nodal metastasis in a young female would attract a recommendation for what therapy?
Cytotoxic chemotherapy
Radiotherapy
Endocrine therapy using letrozole
Endocrine therapy using tamoxifen
A 55-year-old woman presents with creamy nipple discharge. Her last mammography screening done one year ago was normal. She smokes 15 cigarettes per day. Her clinical examination was reassuring. A repeat mammogram was done and no abnormalities were detected. She is worried that it might be a tumour but not annoyed by the discharge itself. Her serum prolactin level is shown below.
Prolactin 200 mIU/L (< 600)
According to the most likely diagnosis, what is the best initial treatment?
Lumpectomy
Mastectomy
Microdochectomy
Reassurance
Total duct excision
Reassurance - No specific treatment is required for duct ectasia
Microdochectomy is used to treat duct ectasia (in young women) if the condition is bothering the patient. It is also used in treating intraductal papilloma.
A patient, 32, who presents with suspected fibroadenoma.
What is the most appropriate next step for this patient? [1]
ultrasound of the lump.
- As the woman is under 35 years of age, an ultrasound is preferred over a mammogram.
Ultrasound of the breast and of the right axillary lymph node show a ‘snowstorm’ sign. What is the most likely diagnosis? [1]
Implant rupture
