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Flashcards in Breast Deck (3)
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1
Q

Breast history - reconstructive

A

General - age, occupation

Breast

  • breast cancer site, type, date of diagnosis
  • risk factors for breast cancer incl FHx, BRCA status
  • surgery to breast/axilla
  • adjuvant treatment incl chemo, DXT, hormonal therapies
  • follow up incl recent mammograms

Aesthetic

  • current bra size
  • use of prosthesis
  • satisfaction with contralateral breast
  • desired bra size / expectations

Surgical risk factors

  • comorbidities
  • anticoagulants

Lifestyle

  • smoking
  • support at home
1
Q

Breast history - aesthetic

A

General - age, occupation

Breast

  • physical symptoms
  • previous history breast disease / FHx breast cancer
  • previous breast surgery

Aesthetic

  • current bra size
  • psychological concerns
  • avoidance behaviour
  • desired bra size / expectations

Surgical risk factors

  • comorbidities
  • anticoagulants

Lifestyle

  • smoking
  • stable weight
  • completion of family
  • support at home
2
Q

Breast examination

A

With pt sitting in front of me

  1. GENERAL - age, skin type, BMI, shape of chest wall
2. BREAST
Inspection 
- front - size, shape, symmetry, skin quality, striae, scars, radiation changes, tethering
- side - ptosis, projection
- back - scoliosis, scars

Measurements

  • pinch test
  • sternal notch>nipple>IMF
  • base width
  • skin deficit
  1. RECONSTRUCTIVE OPTIONS
    Donor sites
    - back - pinch tissue, test LD - THEN ask pt to lie down
    - abdo - pinch tissue, test SLR for divarication of recti
    - others e.g thighs
  2. ONCOLOGICAL EXAM
    - breast - 4 quadrants - THEN sit pt up again
    - axillae
    - supraclavicular