BREAST Flashcards by Hannah Cook

How common are breast abscesses?

a) 1 in 3
b) 1 in 30
c) 1 in 300
d) 1 in 3000

c) 1 in 300

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which age group does breast abscesses mostly affect?

child-bearing females

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what physiological state can predispose to breast abscesses

breastfeeding

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what is the most common cause and organism of breast abscesses?

bacterial infection (s. aureus) causing collection of pus underneath the skin

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What breast condition is breast abscess a severe complication of?

Breat mastitis usually of a lactating women

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What history and examination would indicate breast abscess?

History of mastitis
Fever and general malaise
A painful, swollen lump in the breast, with redness, heat, and swelling of the overlying skin.

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What is the management of breast abscess after confirmation from history and physical examination?

Urgent refferal:

1) Confirmation of the diagnosis (by ultrasound).
2) Drainage of the abscess (by ultrasound-guided needle aspiration or surgical drainage).
3) Culture of fluid from the abscess (which will be used to guide the choice of antibiotic).

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name a complication for breast abscesses

can be pre-malignant

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what antibiotics would you commonly give for
a) Lactating breast mastitis
b) Non lactating breat bastitis
+ analgesia and bath in warm water to relieve pain

a) 10-14 days of flucloxacillin ( cla/erythromycin is alternative)
b) Co Amoxiclav 10-14 days ( Cla/erythromycin + metrionadazole )

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what antibiotics would you give for a MRSA breast abscess

clindamycin

trimethroprim

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what proportion of all female cancers is breast carcinoma?

a) 1/100
b) 1/3
c) 1/50
d) 1/10

b) 1/3

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among which group is breast carcinoma the most common cancer?

non-smokers

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name 5 risk factors for breast carcinoma

female
Previous breast cancer
age >50
late age for first pregnancy >30
early menarche <13
Late menopauce >51
COCP/HRT
family history
obesity
radiation
Absent breast feeding
Mastitis is severe or recurrent.

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Which of these is not a genetic mutation/syndrome responsible for breast cancer?

a) BRCA1/2
b) li Fraumeni
c) Cowden’s
d) familial hyperlipidaemia
e) TP53 mutation

d) familial hyperlipidaemia

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what is HER2 ?

proto-oncogene

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what is an acquired HER2 mutation associated with in terms of breast carcinoma?

worse outcome

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how are HER2 mutations treated?

herceptin

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what type of breast carcinoma is most common?

adenocarcinomas - ductal

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name 4 symptoms that may be present with breast carcinoma

tethering
dippling 
ulceration
New palpable mass (lumo)
Discharge from nipple = blood stained
Unilateral breast stize 
peau d'orange
Rash around nipple
Eczema = Paget disease 
No pain

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what is the triple assessment for breast cancer?

palpation
imaging (mammography/US/MRI)
needle aspiration cytology

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which receptor status brings the best prognosis in breast cancer?

a) oestrogen positive, progesterone positive
b) oestrogen positive, progesterone negative
c) oestrogen negative, progesterone negative
c) oestrogen negative, progesterone positive

a) both positive

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why would radiotherapy be given in breast cancer?

reduce recurrence

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why would chemo be given in breast cancer?

high risk cases

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what is tamoxifen?

oesterogen supressor

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when is tamoxifen used?

oestrogen receptive cancer= it suppresses the receptors and prevent proliferative actions

name 2 drugs that can be used in post-menopausal women to reduce circulating oestrogen

anastrozole letrozole exemestane

which 3 places do breast cancers commonly metastasise

lungs liver bone

how many diagnosed breast cancer patients have NO evidence of nodal mets? a) 5% b) 20% c) 50% d) 80%

b) 20%

what type of women do ductal papillomas normally affect? a) young 20s b) middle aged c) post-menopausal d) elderly

b) middle aged

is breast ductal papilloma more or less common than fibroadenoma?

less

where does breast ductal papilloma occur?

large ducts

what feature might you see in the nipple discharge of a patient with breast ductal papilloma

clear or blood stained discharge

name an observable feature of breast ductal papilloma during investigation

palpable mass= Either one large lump near nipple or Lots of small lumps away from the nipple

what is microdochectomy and when is it used?

removal of affected duct in ductal papilloma

what is Hadfield's procedure and when is it used?

removal of all ducts in breast in ductal papilloma

name a complication for duct papilloma

Generally non pre malignant Unless contain atypical cells then slight increase in risk of developing breast cancer = as you have atypical hyperplasia

how many women of childbearing age are affected by fibrocystic disease of the breast? a) 5% b) 20% c) 50% d) 80%

c) 50%

how would you describe fibrocystic disease to a layman?

non-cancerous breast lump

how is the texture of the breast described in fibrocystic disease?

lumpy/cobblestone

describe 3 features of a fibrocystic breast lump and potential symptoms patient might have?

a) smooth, defined edges, free moving | b) Aching, tenderness thickening and breast pain especially in the affected area.

where in the breast are fibrocystic lumps most commonly found?

upper outer quadrant

how is fibrocystic disease affected by women's hormonal cycle?

follows menstrual cycle- peaks just before period | subsides after menopause

is breast fibrocystic disease likely to increase risk of breast cancer?

no, unless family history already exists

What is mastitis?

A condition that causes breast pain and swelling (inflammation), and usually affects women who are breastfeeding.

Where does lactation abscesscommonly occur?

A lactational abscess is usually located in the peripheral region of the breast, more commonly in the upper and outer quadrant.

When does a patient a with lactation mastitis have there breast milk sampled for microsopy, culture and antibiotic sensitivity?

Mastitis is reccurent or severe Hospital acquired infection is liekly There is a deep burning breast pain ( ductal infection)

What is Li-Fraumeni Syndrome?

rare inherited genetic cancer disorder that greatly increases one's risk of developing cancer during their lifetime

What is Cowden syndrome?

It is a rare autosomal dominant inherited disorder characterized by multiple non-cancerous tumor-like growths called hamartomas= Increase the chance of breast cancer

Where is HER2 normally found?

It is found on the surface of normal breast cells.

What is the function of HER2 and what is the name for high levels of the protein?

Extra number of HER2 stimulates growth and differentiation of breast cancer In this stage it is called= HER2 positive breast cancer.

What is the staging of breast cancer?

Stage 0= Non invasive breast cancer= for example ductal carcinoma in situ Stage 1= Cancer cells have brocken through the breast tissue and starting to invade the surrounding tissue Stage 2= Further invasion of surrounding tissue and tumour growth of less than <5cm Stage 3= Further growth and lymph involvement Stage 4= Mets

what is a very common benign breast conidtion in young females?

• Fibroadenoma

When is MRI used for breast screening?

When you have high risk of breast cancer due to bRCA genes | Lobular breast cancer

What is the advantage of mamogram screening?

Can look at the whole breast

Eczema like rash on the breast can be a indication of what condition?

Paget disease of breast

What does paget disease of the breast indicate?

is often associated with an underlying in-situ or invasive carcinoma of the breast

What is breat ductal papilloma?

Benign epithelial tumor growth in the breast

How do you diagnose breast ductal papilloma?

Triple assessment palpation imaging (mammography/US/MRI) needle aspiration cytology

What history would be indicative of breast mastitis?

A painful breast. Fever and/or general malaise. A tender, red, swollen, and hard area of the breast, usually in a wedge-shaped distribution.

When is it more likely for a mastitis to be infected?

If they have nipple fissure or are lactating?

What is the advice for a breast feeding patient if they have mastitis or breast abscess?

To keep breast feeding

What is HER2?

Human epidermal growth factor

BREAST Flashcards

(62 cards)