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ABSITE > Breast > Flashcards

Breast Flashcards

1
Q

Stewart-Treves syndrome

A

Lymphangiosarcoma
Originates in vascular endothelial cells in chronic lymphedema

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2
Q

Mondor disease

A

Thrombophlebitis of lateral thoracic or superior thoracoepigastric vein -> tender, subcutaneous cord in breast tissue

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3
Q

Radial scar found on core biopsy - next step?

A

Excisional biopsy because they may be associated with malignancy

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4
Q

Cowden syndrome surveillance

A

Breast exam q6mo with imaging (alternating MRI and mammogram)

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5
Q

Breast cancer in 1st trimester of pregnancy - management

A

Recommend termination of pregnancy; if not, mastectomy with axillary staging

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6
Q

Breast cancer in 2nd trimester of pregnancy - management

A

Mastectomy with axillary staging, or neoadjuvant chemo followed by breast conserving therapy.
Then postpartum radiation and endocrine therapy

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7
Q

Breast cancer in 3rd trimester of pregnancy - management

A

Same as any non-pregnant patient

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8
Q

Surgical treatment of gynecomastia

A

Excision of glandular tissue and liposuction of surrounding adipose tissue

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9
Q

Management of mild/moderate mastodynia (cyclical breast pain)

A

Conservative therapy, OTC pain meds, and lifestyle changes (avoid caffeine and chocolate)

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10
Q

Management of severe mastodynia

A

Tamoxifen (SERM), danazol (antigonadotropin), or bromocriptine (third line if refractory to danazol)

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11
Q

Lifetime risk of breast cancer if BRCA+

A

37-85%

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12
Q

Most frequent presentation of DCIS on mammogram

A

Clustered microcalcifications on mammogram

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13
Q

Diagnosis of inflammatory breast cancer

A

Acute onset of symptoms <6mo and pathologic confirmation

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14
Q

Management of inflammatory breast cancer

A

Neoadjuvant chemo, modified radical mastectomy, and adjuvant radiation with endocrine therapy
[Lymph node biopsy is contraindicated because tumor cells may plug dermal lymphatics]

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15
Q

Mammogram screening should start at age

A

40

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16
Q

Indication for PARP inhibitors (eg, Olaparib) in breast cancer

A

Adjuvant therapy for patients with triple negative breast cancer, and are BRCA+

17
Q

Histologic findings of Paget disease

A

Large cells with pale cytoplasm and prominent nucleoli in epidermis

18
Q

Li-Frameni syndrome manifestations

A

Breast cancer, soft tissue sarcoma, osteosarcoma, brain tumors, adrenal tumors, Wilms tumor, phyllodes tumor, pancreatic cancer, leukemia, neuroblastoma

19
Q

Pathology of LCIS

A

Small uniform cells confined to lobule

20
Q

Innervation of pec major

A

Medial pectoral nerve (upper part) and lateral pectoral nerve (lower part)

21
Q

Margins for DCIS

A

2mm

22
Q

E-cadherin staining in breast lesion

A

Atypical ductal hyperplasia

23
Q

Margins for Phyllodes tumor

A

1cm margins

24
Q

Indications for adjuvant chemotherapy in breast cancer

A

Nodal disease, tumor >1cm, and pathologic specimens with evidence of aneuploidy

25
Q

Mechanism of tamoxifen

A

Competitive estrogen antagonist in breast
Partial agonist in non-breast tissue (uterus, liver, bone)

26
Q

Amplification of this biomarker is associated with the worst prognosis in breast cancer

A

HER2

27
Q

Breast pathology: cells with enlarged nucleoli interspersed with keratinocytes

A

Paget disease

28
Q

Risk of developing invasive breast cancer after diagnosis of LCIS

A

25-35% lifetime risk

29
Q

Mechanism of gynecomastia development

A

Decrease in androgen/testosterone production with resulting increase in estrogen

30
Q

Innervation of pec minor

A

Medial pectoral nerve

31
Q

Blood supply for a TRAM flap

A

Superior epigastric vessels

32
Q

Blood supply for latismuss dorsi flap

A

Thoracodorsal artery

33
Q

Most common cause of Mondor disease

A

Idiopathic

34
Q

When to not breastfeed with mastitis

A

If there is purulent discharge

35
Q

Borders for axillary lymph node dissection

A

Medial: serratus anterior
Lateral: anterior border of latissimus dorsi
Posterior: subcapsularis muscle
Superior: axillary vein
(Inferior border is less standard)

36
Q

Anatomic borders of axilla

A

Apex: posterior border of clavicle
Anterior: pec major and minor
Posterior: subcapsularis
Medial: serratus anterior overlaying first 4 ribs and chest wall
Lateral: anterior border of latissimus dorsi

37
Q

Which levels of axillary lymph nodes are taken for breast cancer?

A

Levels 1 and 2

38
Q

Which levels of axillary lymph nodes are taken for melanoma?

A

Levels 1, 2, and 3

39
Q

When to start breast cancer screening if BRCA+

A

Age 25 with yearly MRI and clinical breast exams every 6-12 months (add mammogram to screening at age 30)

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