Breast

Question 1

What are the three components of a triple assessment?

Answer 1

clinical assessment
imaging assessment
needle biopsy

Question 2

Lifetime risk of developing breast cancer

Answer 2

1 in 8

Question 3

Lower risk of developing breast cancer

Answer 3

longer duration of breastfeeding
increasing parity
earlier age at first birth

Question 4

Higher risk of breast cancer

Answer 4

FH
HRT use
earlier menarche

Question 5

things marked 1-5 in triple assessment

Answer 5

Palpation
ultrasound/Mammography
cytology

Question 6

Paget’s disease

Answer 6

looks like eczema or psoriasis but on one breast

Question 7

Swelling of arm after breast cancer

Answer 7

Axillary node clearance

Question 8

two angles of mammography

Answer 8

mediolateral oblique

craniocaudal

Question 9

Grade of breast cancer shows how…

Answer 9

aggressive the cancer is

Question 10

HER2 positive spread faster or slower?

Answer 10

faster

Question 11

invasive lobular carcinoma- what scan is nneded

Answer 11

MRI- identifies extent of cancer

Question 12

IF P4 but M0 and U0- what next

Answer 12

clinical (freehand) core biopsy

Question 13

if positive for cancer, where scan next?

Answer 13

axilla

Question 14

ER pos, HER2 neg. What treatment?

Answer 14

Tamoxifen

Question 15

HER2 pos- what treatment?

Answer 15

trastuzumab

Question 16

what is the aim of chemo?

Answer 16

to eradicate micrometastatic disease

Question 17

what three characteristics are used to determine stage?

Answer 17

tumour size, number of lymph nodes involved, presence of mets

Question 18

triple neg breast cancer means

Answer 18

no HER2, ER or PR receptors

Question 19

What tool can be used to estimate breast cancer survival

Answer 19

PREDICT

Question 20

Side effects of tamoxifen

Answer 20

endometrial thickening, DVT, menopausal symptoms, cataracts

Question 21

Small lumps on nipple.

Answer 21

Montgomery tubercles- can be normal but become more pronounced in pregnancy

Question 22

Cyclical breast pain

Answer 22

usually more in menstrual cycle
settles down by itself
stops after menopause

Question 23

non cyclical breast pain

Answer 23

could be costochondritis, causes are often unclear and resolves itself

Question 24

patient report cyclical type breast pain. Next step

Answer 24

reassure, offer bilateral mammogram

Question 25

painful area in breast. red and tender. Beginning to feel tired and unwell. had baby 5 weeks ago

Answer 25

lactational mastitis- can be infectious or non infectious

Question 26

Lump in context of lactational mastitis

Answer 26

could be an abscess- ultrasound it.

Question 27

abscess present- what next

Answer 27

ultrasound guided drainage. send fluid to microbio. start fluclox

Question 28

red, swollen, hot breast. Not lactating

Answer 28

consider inflammatory breast cancer- can mimic mastitis and breast abscesses

Question 29

treatments to consider in pts with breast pain

Answer 29

NSAIDS, danazol

Question 30

do you stop breastfeeding in mastitis

Answer 30

no- feed on demand from both breasts unless too painful

Question 31

predisposing factors for breast abscess

Answer 31

immunocompromised, diabetes, nipple piercing, smoking

Question 32

Breast implant problems

Answer 32

could be PIP implants (wrong grade silicone) | leaking implant

Question 33

Investigation with implant problems

Answer 33

Ultrasound | MRI

Question 34

Young female with breast lump

Answer 34

fibroadenoma

Question 35

even if thinking fibroadenoma- what next

Answer 35

triple assess- palpate, image, biopsy (if over 25)

Question 36

imaging in woman over 40

Answer 36

mammogram and ultrasound

Question 37

blood stained cyst fluid- what next?

Answer 37

send for cytology

Question 38

what type of gene is BRCA

Answer 38

tumour suppressor protein

Question 39

inheritance of BRCA

Answer 39

autosomal dominant

Question 40

chromosomes with BRCA

Answer 40

13 and 17

Question 41

prophylactic mastectomy reduces risk of cancer by what percent

Answer 41

90

Question 42

herceptin

Answer 42

HER2 cancers