Flashcards in Breast 2 Deck (19):
Ulcerated breast lesion with underlying mass – diagnosis?
Prognosis compared to infiltrating ductal carcinoma?
Inflammatory carcinoma; Worse prognosis than ductal carcinoma
Edema over skin underlying breast mass – diagnosis? Worse prognosis is?
Invasion of the local dermal lymphatics
Extensive edema of the breast – differential?
1. Inflammatory carcinoma
3. breast abscess
Retraction of the skin overlying breast mass suggests in invasion of?
Invasion of breast support structures and lymphatics
Patient with two previous aspirations of fluid from cystic mass in breast – mass keeps recurring - next step?
Excise cysts to rule out cancer
Patient with the .5 cm breast mass fixed to the deeper tissues. Fixation to the chest wall indicates? Effect on the prognosis?
Invasion of structures outside the breast
Patient with breast mass and lymph node palpable in the supraclavicular area – indicates?
Stage IV disease with distant metastases. Unresectable and incurable
Patient with breast mass – Hard fixed node in axilla versus soft lymph node?
metastases or inflammation
Breast mass and small nodes on skin of breast – likely diagnosis?
Satellite nodules of carcinoma
61-year-old woman presents with crusty lesion on the right nipple – likely dx? Next Steps? Treatment?
Paget's disease – Underlying infiltrating ductal carcinoma or DCIS
1. Mammography an exam for mass
2. Biopsy any mass
3. If confined to nipple, excision of nipple areolar complex or radiotherapy
Breast anatomy – main structures? Arterial supply? Venus return? Lymphatics?
1. 15-20 lobes each with 20-40 lobules
2. Ducts drain each lobe
Internal mammary and lateral thoracic
Axillary and internal mammary vein
Axillary lymph node chain
Modified radical mastectomy – removes? Adjunct radiation if?
Most common mastectomy
Removes breast tissue, skin, axillary lymph nodes. Spares pectoralis major.
Local Radiation if:
1. greater than 5 cm
2. involve margins
3. invade fascia/muscle
Axillary radiation if More than four lymph nodes involved
Radical mastectomy – removes?
Breast tissue, skin, pectoralis minor and major, axillary lymph nodes
Simple mastectomy removes? Typical used with?
Breast tissue, nipple-areolar complex, skin
LCIS board DCIS
Subcutaneous mastectomy removes? How common?
Breast tissue only; rarely indicated
Lumpectomy – when to perform? Removal of?
Solitary tumor less than 5 cm in size if patient is a good candidate for postoperative radiation
1. primary lesion with clear gross and histologic margins
2. axillary node sampling
3. local radiotherapy of breast
Do not perform modified radical mastectomy for tumors less than this size?
Method for lymph node sampling in breast cancer?
Sentinel node biopsy with technetium or Isosulfan blue