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Flashcards in breast Deck (47):
1

What is the location of the greatest volume of the breast

upper outer quadrant

2

Blood supply of breast

1. internal mammary artery
2. posterior intercostal artery
3. branches of axillary artery

3

Venous drainage of breast

1. internal thoracic vein
2. posterior intercostal vein
3. branches of axillary vein

4

Possible route for breast cancer metastases to the vertebrae, skull, pelvic bones and CNS

Batson's vertebral plexus

5

Most common site of axillary LN metastasis

Lateral/ axillary vein group - I

6

This hormone promotes ductal development of breast

estrogen

7

This hormone promotes lobular development of breast

progesterone

8

Treatment of breast abscess

1. pre operative ultrasound
2. incision and drainage - with suppuration
3. local wound care - antibiotics and warm compress

9

This is a recurrent retroareolar infection and abscess of the breast

Zuska's disease (recurrent periductal mastitis)

10

A benign self limited condition which is a variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast

mondor disease

11

Treatment of mondor disease

1. anti inflammatory medications
2. war compress
3. restriction of motion
4. brassiere support

12

What is a size of a giant fibroadenoma

> 3 cm

13

Treatment of fibroadenoma

1. cryoablation
2. surgical removal
3. observe

14

This occurs when the stroma of the breast involutes too quickly and the alveoli remains.

Breast Cyst

15

Management of breast cyst

Core needle biopsy

16

Definition of microcalcification

1. < 0.5 mm
2. fine
3. linear
4. branching

17

It occurs in premenopausal women with serous or bloody nipple discharge

intraductal papilloma

18

What age to perform baseline mammography

35 y.o

19

What age to do annual mammogram

40 y.o

20

What is the treatment if there is mutation in HER 2 gene

herceptin/trastuzumab

21

Most common sign of breast CA

Mass

22

Where is BRCA 1 located

chromosome 17q
-develops invasive ductal carcinoma
-poorly differentiated
-hormone receptor negative

23

Where is BRCA 2 located

Chromosome 13q
-develops invasive ductal carcinoma
-well differentiated
-hormone receptor positive

24

Most important prognostic correlate of disease free and overall survival of breast CA

axillary lymph node status

25

Most common sites of metastases in breast CA

1. bone
2. lung
3. pleura
4. soft tissue
5. liver

26

Treatment of LCIS

1. observation
2. chemoprevention with tamoxifen and bilateral total mastectomy
3. close follow up with PE and bilateral mammograms

27

Treatment of DCIS

1. >4 cm or >1 quadrant - mastectomy
2. low grade DCIS (cribriform or papillary subtype) and < 0.5 cm - lumpectomy

28

What is the pathognomonic finding of Paget's disease of nipple

large, pale, vacuolated cells in the rete pegs of the epithelium

29

Paget disease is positive for what marker

CEA

30

It is a multifocal, multicentric and bilateral breast cancer with signet ring cells

invasive lobular carcinoma

31

What test is used in nipple discharge

ductography

32

Treatment of early invasive breast cancer (stage I, IIA, IIB)

Breast conservation surgery
1. lumpectomy
2. radiation therapy

33

Contraindication to breast conservation surgery

1. prior RT
2. unknown margin status
3. multicentric disease
4. scleroderma or SLE

34

Treatent of advanced local regional breast cancer (IIIA, IIIB)

1. surgery - MRM
2. adjuvant RT
3. chemotherapy - neoadjuvant

35

5 year survival rate of breast cancer

I - 94%
IIA - 85%
IIB - 70%
IIIA - 52%
IIIB - 48%
IV - 18%

36

This surgery is the removal of all breast tissue, nipple areola complex, skin and level I LN

extended simple mastectomy

37

What comprises a MRM

1. removal of all breast tissue
2. nipple areola complex
3. level I and II LN
4. skin

38

This surgery removes all breast tissue and skin, nipple areola complex, pectoralis major and minor, and level I, II, III LN

halstead radical mastectomy

39

Most frequent complication of MRM

seroma

40

treatment of pregnant breast CA

1st and 2nd trimester - MRM
3rd trimester - lumpeectomy with Axillary ND and RT after delivery

41

Treatment of Phylloides tumor/cystosarcoma

Benign - total excision with 2 - 3 cm margin
Malignant - total mastectomy WITHOUT` LN dissection

42

It is a variant of infiltrating ductal carcinoma characterized by skin changes of brawny induration, erythema with a raised edge, and edema/ peau d orange

inflammatory breast cancer

43

what causes the appearane of inflammatory breast cancer

dermal lymphatic invasion

44

This surgery is the removal of all breast tissue, nipple areola complex, skin

total (simple) mastectomy

45

This presents as a chronic, erythematous, eczematoid rash or ulcer and is associated with DCIS and invasive cancer of the breast

Paget's disease

46

Treatment of Paget's disease

1. lumpectomy
2. mastectomy
3. MRM

depends on the extent of involvement and presence of invasive cancer

47

This drug is quoted as medical adrenalectomy

anastrazole - inhibit production of adrenal steroid and conversion of androgen to estrogen in the adrenal gland and peripherally