Breast

Question 1

what is mastitis

Answer 1

inflammation of the breast tissue

Question 2

epidemiology of mastitis

Answer 2

women who breastfeed

Question 3

what organism causes mastitis

Answer 3

staph aureus

Question 4

how does mastitis present

Answer 4

red painful breast (painful breastfeeding)
fever

Question 5

how to manage mastitis

Answer 5

i) continue breastfeeding
ii) flucloxacillin for 10 days if not improved after 2 days

Question 6

complication of mastitis and its treatment

Answer 6

• abscess formation
• drainage

Question 7

epidemiology of duct ectasia

Answer 7

post menopausal women over 50s

Question 8

presentation of duct ectasia

Answer 8

green nipple discharge
painful lump around areola

Question 9

what is the most common type of breast cancer

Answer 9

invasive ductal carcinoma

Question 10

what is a risk factor for breast cancer

Answer 10

prolonged oestrogen exposure
- early menarche, late menopause
- OCP, HRT
- no pregnancy

Question 11

what are the genes for breast cancer

Answer 11

BRCA1 & BRCA2

Question 12

what are 3 presentations of breast cancer

Answer 12

• painless lump
• Paget’s disease of the nipple (itchy, painful, yellow discharge)
• axillary lymphadenopathy

Question 13

what is the screening programme for breast cancer

Answer 13

• aged 50-70 mammogram every 3 years
• yearly mammogram from age 40 if family history

Question 14

what are the criteria for a 2ww referral for suspected breast cancer

Answer 14

• older than 30 with a lump
• older than 50 with unilateral nipple symptoms

Question 15

what are the criteria for a non-urgent referral for suspected breast cancer

Answer 15

• younger than 30 with a lump

Question 16

what is the triple assessment of the breast

Answer 16

1. clinical examination
2. US if < 40 or mammogram + US if > 40
3. biopsy (fine needle aspiration)

Question 17

blood test for breast cancer

Answer 17

check for invasive cancer receptors
- ER
- PR
- HER2

Question 18

steps to treating breast cancer

Answer 18

i) is there palpable lymphadenopathy
- YES: clear it during surgery
- NO: do a pre-op US with lymph node biopsy

ii) surgery
- mastectomy if multifocal or big
- wide local excision if small or peripheral

iii) radiotherapy (always done after local excision)

iv) receptor target medication

Question 19

what medication do you give for HER +ve breast cancer

Answer 19

trastuzumab

Question 20

what medication do you give for ER +ve breast cancer

Answer 20

• post-menopausal: anastrazole
• pre-menopausal: tamoxifen