Breast Flashcards
(104 cards)
1
Q
at what week of gestation does mammary ridges appear?
A
5th or 6th week of gestation
2
Q
___ syndrome is associated with amastia
A
poland syndrome
3
Q
the breast is composed of how many lobes?
A
15 to 20 lobes
4
Q
this quadrant contains the greater volume of tissue compared to all other quadrants
A
upper outer quadrants
5
Q
___ artery are the perforators of the breast
A
internal mammary artery
6
Q
blood supply of the breast
A
internal mammary artery
posterior intercostal artery
branches from axillary artery
7
Q
this provides a route for breast cancer metastatsis to the vertebra
A
batson vertebral plexus
8
Q
batson vertebral plexus extends from the ___
A
base of the skull of the sacrum
9
Q
What innervates the breast?
A
- lateral cutaneous branch from the 3rd to 6th intercostal nerves
- Intercostobrachial nerve (from the 2nd intercostal nerve)
- Supraclavicular nerve from the cervical plexus
10
Q
Level I breast lymphatics are composed of
A
- Scapular group
- External mammary group
- Axillary vein grooup
11
Q
Level II breast lymphatics are composed on
A
- central group
2. Interpectoral group
12
Q
Rotter nodes are also called
A
interpectoral group
13
Q
Level III breast lymphatics are composed of
A
Subclavicular group
14
Q
Estrogen plays a role ____ development
A
ductal development
15
Q
Progesterone plays a role in ____
A
lobular development
16
Q
____ plays a role in lactogenesis
A
prolactin
17
Q
___ syndrome predisposes a male to breast cancer
A
Klinefleter syndrome
18
Q
[Gynecomastia Grading]
mild enlargement without skin redundancy
A
Grade I
19
Q
[Gynecomastia Grading]
moderate breast enlargement without skin redundancy
A
Grade IIa
20
Q
[Gynecomastia Grading]
moderate enlargement with skin redundancy
A
Grade IIb
21
Q
[Gynecomastia Grading]
marked enlargement with skin redundancy and ptosis
A
Grade III
22
Q
Drug treatment for gynecomastia
A
Danazol
23
Q
[pharma]
drug of choice for gynecomastia with androgen deficiency
A
testosterone administration
24
Q
Etiologic agent for epidemic puerperal mastitis via the suckling neonate
A
MRSA
25
Etiologic agent for non-epidemic mastitis
S. aureus.
26
___ is also called recurrent peri-ductal mastitis
Zuska Disease
27
Recurrent retroareaolar infections and abscesses of the periductal mastitits
zuska disease
28
Variant of thrombophlebitis that involves the superficial veins of the anterior chest wall and breast
mondor disease
29
[diagnose]
acute pain at the lateral aspect of the breast, tender, firm cord following the distribution of the veins
mondor disease
30
[Is there a risk for malignancy in this lesion?]
mild ductal epithelial hyperplasia
none
31
[Is there a risk for malignancy in this lesion?]
duct ectasia
none
32
[Is there a risk for malignancy in this lesion?]
sclerosing adenosis
no to slightly increased risk
33
[Is there a risk for malignancy in this lesion?]
florid ductal epithelial hyperlasia
no to slightly increased risk
34
[Is there a risk for malignancy in this lesion?]
intraductal papillomas
no to slightly increased risk
35
[diagnose]
well-defined mass, UO quadrant, enlarges before the onset of her period
fibrocystic disease of he breast
36
most common cause of bloody nipple discharge
intraductal papilloma
37
[diagnose]
well circumscribed painless rubbery movable discrete borders
fibroadenoma
38
Smoking ___ (is/ is not) a risk factor for breast CA
not a risk factor
39
At what age will you request for a baseline mammogram
35
40
annual mammogram shall be done beginning ___ age
40
41
[BRCA Mutations]
BRCA 1 is located in what chromosome?
Chr 17
42
[BRCA Mutations]
this is associated with poorly differentiated CA and hormone receptor negative
BRCA 1
43
[BRCA Mutations]
early onset, bilateral disease
CA at other sites
BRCA 1
44
[BRCA Mutations]
BRCA II is located in what chromosome?
Chromosome 13
45
[BRCA Mutations]
Associated with breast CA in men
BRCA II
46
[BRCA Mutations]
this is associated with well differentiated CA
and express hormone receptor
BRCA II
47
[BRCA Mutations]
Age at which mammogram should be done yearly
25
48
[BRCA Mutations]
age at which CA 125 yearly beginning at age 25
25 years old
49
If the mass is around 1cm, it has been present for how many years?
5 years
50
Nipple changes in breast CA is due to
shortening of coopers sensory ligament
51
it is the most important prognostic correlate of disease-free and overall survival
axillary lymph node status
52
Peau d orang e is due to
blockage of lymph node drainage
53
Metastatic foci occirs when the primary Ca exceeds in ___ cm
0.5
54
[Primary Breast CA]
originates from the terminal duct lobular units
(+) neighborhood calcifications
marker of increased risk for invasive CA
LCIS
55
[Primary Breast CA]
due to proliferation of the epithelium
calcification occurs in the areas of necrosis
DCIS
56
[Primary Breast CA]
a true anatomic precursor of invasive CA
DCIS
57
[Primary Breast CA]
paget disease is associated with this CA
DCIS
58
[Primary Breast CA]
In lobular CA, the subsequent cancers is located
bilaterally
59
[invasive breast CA]
large, pale, vacuolated cells in the rete pegs of epithelium
(+) CEA
(-) S-100
Paget disease
(+) S-100 - melanoma
60
most common type of invasive breast CA
invasive ductal CA
61
[diagnose]
central stellate configuration with chalky white or yellow streaks
invasive ductal CA
62
[invasive breast CA]
this is the frequent phenotype of BRCA1 cancers
medullary CA
63
[diagnose]
mass that is soft, hemorrhagic, bulky
dense lymphoreticular infiltrate of lymphocytes and plasma cells
large pleomorphic nuclei that are poorly differentiated sheet-like growth pattern
medullary CA
64
[invasive breast CA]
usually seen in elderly population
glistening and gelatinous mass
colloid CA
65
[invasive breast CA]
presents in 70 year old woman, small, rarely attain a size of 3cm
papillary CA
66
[invasive breast CA]
perimenopausal or early menopausal periods
distant metastasis are ra
haphazard array of small tubular elements
tubular CA
67
[invasive breast CA]
absence of E-cadherin
invasive lobular CA
68
[invasive breast CA]
small cells arranged in single file orientation
intracytoplasmic mucin that may display the nucleus (signet ring CA)
invasive lobular CA
69
Cite the risk factors of breast CA
1. increased estrogen exposure
2. Radiation exposure
3. increased alcohol intake
4. high fat diet
5. prolonged OCP use
6. Prolonged HRT use
7. Family history
70
Cite the specific mammographic features of malignant breast CA
1. Solid mass with or without stellate features
2. Asymmetric thickening of tissues
3. clustered microcaclficiations
71
[BIRADS Category]
probably benign
<2% risk of malignancy
BIRADS 3
72
[BIRADS Category]
Recommendation for BIRADS 3
short interval follow-up every 6 months, then every 6 to 12 months
73
What BIRADS category will you perform biopsy (needle)
BIRADS 4A, B, C
74
What is the primary indication for ductography
nipple discharge especially when the fluid contains blood
75
Imaging modality for younger females to screen for breast CA
UTZ
76
What is the screening modality for women with BRCA mutation?
MRI
77
diagnostic modality for premenopausal woman with a family history of breast CA
breast UTZ
78
ER/PR flow studies can be done in this type of breast biopsy technique
incisional biopsy
| excisional biopsy
79
breast biopsy technique used for non-palpable masses
wire or needle directed excisional biopsy
80
[Breast CA Staging]
T2 N1 M0
T2: Tumor is greater than 2 cm but less than 5cm
N1 : mets movable ipsilateral ALN
81
[Breast CA Staging]
N3 means
mets in ipsilateral ALN and internal mammary LN or inflaclavicular LN or supraclavicular LN
82
[SLNB Recommendations]
SLNB negative
No further axillary dissection
83
[SLNB Recommendations]
SLNB positive
200 cells, larger than 0.2mm, but none larger than 2.0mm
no further LN dissection
84
[SLNB Recommendations]
SLNB positive
but T1 or T2, 1 or 2 positive sentinel LN
Breast conserving surgery, Whole-breast RT planned, no preopeartive chemo
No further LN dissection
85
[SLNB Recommendations]
SLNB not identified
do Axillary LN dissection
86
[Type of mastectomy]
Simple Mastectomy +
Removal of axillary LN
+ removal of pectoralis minor
MRM, Patey
87
[Type of mastectomy]
Simple Mastectomy +
Removal of axillary LN
+ preserve pectoralis minor
MRM, Madden and Auchinocloss
88
[Type of mastectomy]
Simple Mastectomy +
Removal of axillary LN
+ transect pectoralis minor then repair of transected muscle
MRM, scanlon
89
[Type of mastextomy]
Remove entire breast, axillary LN,
+ Pectoral Minor + Pectoral major
Radical Mastectomy
90
[complications of mastectomy]
Protraction of scapula: ___ nerve and muscle
Long thoracic, serratus anterior
91
[complications of mastectomy]
Extension and adduction of shoulder: ___ : _____
Thoracodorsal, latissimus dorsi
92
[complications of mastectomy]
The pectoralis minor and major are damaged. What nerve is affected?
lateral pectoral nerve
93
[complications of mastectomy]
loss of sensation of medial upper arm
intercostobrachial
94
[Advanced locoregional breast CA]
Neoadjuvant chemotherapy is indicated in what stages of CA
Stage IIIa, Stage IIIb
95
Most common site of breast CA metastasis
Liver, Lungs
96
Breast cancer treatment during the 1st and 2nd trimester
MRM
97
breast CA treatment in 3rd trimester?
BCS
98
[Follow-up after treatment]
In the first 2 years
every 4 months
99
[Follow-up after treatment]
In the next 3 years (after 2 years of treatment)
every 6 months
100
[Follow-up after treatment]
Mammogram of the contralateral breast is done every ____
yearly
101
[Type of mastectomy]
Modified radical mastectomy removes axillary LN level ___ and ____
Level I and II
102
[Type of mastectomy]
This type removes
ALL breast tissue, skin, NAC
pectoralis major
pectoralis minor
level I, II and III LN
Halsted Radical Mastectomy
103
___ drugs used for medical adrenalectomy
anastrazole
104
drug that inhibits production of adrenal steroids and conversion of androgens to estrogens in the adrenal gland and peripherally
anastrazole
