Breast surgery Flashcards
Two main categories of breast surgery
Conservative and mastectomy
In wide local excision what the aim for margin distance?
1cm
When is wire-guided excision used?
When the mass is impalpable
What is the aim of neoadjuvant therapy?
Shrink the tumour before surgery- reduces mastectomy rates
What is used for neoadjuvant therapy? (3)
Chemo
Endocrine- aromatase inhibitors or tamoxifen
Herceptin
What is oncoplastic surgery?
Surgery combining principles of oncology and plastic surgery to achieve excision with minimal tissue deformity
When is mastectomy indicated? (3)
Large tumours
Multifocal tumours
Local recurrence following conservative management
If breast reconstruction is immediate, what is “left over” from the mastectomy?
Skin flap
Two types of breast reconstruction
Implant-based (+/- autologous cell matrix)
Autologous
Process of implant-based reconstruction
Use of tissue expanders prior to insertion of permanent implant
Sources of autologous material for reconstruction (4)
Lat.dorsi muscle
Transversus rectus abdominus (TRAM)
Perforator flaps- deep inguinal, inferior gluteal
advantage of DIEP/IGAP over lat dorsi or TRAM
Are muscle-free grafts
How can axillary disease be detected pre-surgery?
Ultrasound of the axilla with core biopsy
What are the options for axillary treatment? (3)
Sentinel node biopsy
Axillary clearance
Axillary radiotherapy
