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Flashcards in Breast 2 Deck (19):
0

Ulcerated breast lesion with underlying mass – diagnosis?

Prognosis compared to infiltrating ductal carcinoma?

Inflammatory carcinoma; Worse prognosis than ductal carcinoma

1

Edema over skin underlying breast mass – diagnosis? Worse prognosis is?

Peau d'orange

Invasion of the local dermal lymphatics

2

Extensive edema of the breast – differential?

1. Inflammatory carcinoma
2. Cellulitis
3. breast abscess

3

Retraction of the skin overlying breast mass suggests in invasion of?

Invasion of breast support structures and lymphatics

4

Patient with two previous aspirations of fluid from cystic mass in breast – mass keeps recurring - next step?

Excise cysts to rule out cancer

5

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

Worsens prognosis

6

Patient with breast mass and lymph node palpable in the supraclavicular area – indicates?

Stage IV disease with distant metastases. Unresectable and incurable

7

Patient with breast mass – Hard fixed node in axilla versus soft lymph node?

Metastases

versus

metastases or inflammation

8

Breast mass and small nodes on skin of breast – likely diagnosis?

Satellite nodules of carcinoma

9

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

10

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

11

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

12

Radical mastectomy – removes?

Breast tissue, skin, pectoralis minor and major, axillary lymph nodes

13

Simple mastectomy removes? Typical used with?

Breast tissue, nipple-areolar complex, skin

LCIS board DCIS

14

Subcutaneous mastectomy removes? How common?

Breast tissue only; rarely indicated

15

Lumpectomy – when to perform? Removal of?

Solitary tumor less than 5 cm in size if patient is a good candidate for postoperative radiation

Removal of
1. primary lesion with clear gross and histologic margins
2. axillary node sampling
3. local radiotherapy of breast

16

Do not perform modified radical mastectomy for tumors less than this size?

2 cm

17

Method for lymph node sampling in breast cancer?

Sentinel node biopsy with technetium or Isosulfan blue

18

Survival in Modified radical mastectomy versus lumpectomy with radiation?

No difference in stage one or two disease