Breast Disorders

Question 1

The proportion of women that will be diagnosed with breast cancer in their life?

Answer 1

1/8

Question 2

Where does breast cancer usually metastasize

Answer 2

Question 2

Genetics of Breast Cancer

Answer 2

Question 2

Primary Risk Factors of Breast Cancer?

Answer 2

Question 3

Reproductive/Physical/Lifestyle Risk Factors for Breast Cancer

Answer 3

Question 4

Invasive Ductal vs. Invasive Lobular Carcinoma?

Answer 4

Question 5

Molecular factors impacting Breast Cancer?

Answer 5

Question 6

Principles of screening for a disease

Answer 6

• Disease screened for represents an important health problem
• It has a well-understood natural history
• It has a recognizable early stage
• There is a benefit to early treatment
• There is a suitable test
• There are adequate facilities to diagnose and treat the condition
• Screen can be done at intervals to match the natural history
• There is less harm than benefit

Question 7

Screening for Breast Cancer

Answer 7

Question 8

Imaging for Breast Cancer

Answer 8

Question 9

Types of biopsy for Breast Cancer

Answer 9

Core biospies have largely replaced fine needle aspiration cytology due to the addition information provided by core biopsy (Architecture of lesion/ Cellular appearance)

Question 10

Staging of Breast Cancer?

Answer 10

TNM classification, based on tumour size, number of nodes involved and evidence of distant metastases

T Staging

• T1: <2cm
• T2: 2-5cm
• T3: > 5cm
• T4: extends to skin/chest wall

N Staging

• N0: No Nodes
• N1: Mobile Ipsilateral Nodes
• N2: Fixed Ipsilateral Nodes
• N3: Infra/supra clavicular or internal mammary nodes

M Staging

• M0: No distant disease
• M1: Distant Disease

Question 11

Indications for Mastectomy?

Answer 11

• Lcoally advanced tumours
• Large tumour to breast volume ration
• Central tumours involving nipple
• Recurrent breast cancer
• Multifocal or widespread

Question 12

Various forms of mastectomy available

Answer 12

Question 13

Indications for Sentinel Lymph node biopsy (SLNB) in breast cancer?

Answer 13

Question 14

Indications for Axillary Lymph node clearance in breast cancer?

Answer 14

Question 15

Types of Breast Reconstruction

Answer 15

Question 16

Adjuvant treatment options for breast cancer?

Answer 16

Question 17

Goal/Indication of Radiotherapy in treating breast cancer

Answer 17

Question 18

Goal/MOA of Hormone Manipulation in treating breast cancer

Answer 18

Question 19

Indication/Example of Chemotherapy in treating breast cancer

Answer 19

Question 20

What is the Oncotype DX Score?

Score thresholds?

Answer 20

21 genome panel that assesses if a patient with luminal breast cancer will benefit from adjuvant chemotherapy (Between 0 and 100)

• Oncotype DX score ≥ 26: hormone therapy and chemotherapy
• Oncotype DX score is ≤ 25: hormone therapy alone

Question 21

Complete absence of the nipple, usually unilateral

Answer 21

Athelia

Question 22

Accessory or supernumerary nipples

Answer 22

Polythelia

Question 23

Congenital absence of breat tissue, nipple remains present

Answer 23

**Amastia**

Question 24

Absence/ underdevelopment of pectoralis muscle, cutaneous ipsilateral syndactyly, hypoplasia of the breast tissue

Answer 24

**Poland's Syndrome**

Question 25

_______________________; - Develop from a whole breast lobule and contain a combination of proliferating epithelium and connective tissue - Most common in females < 30 years old, can occur at any age Management?

Answer 25

**Fibroadenoma** Management: - Simple reassurance - May require excision if > 3-4cm or patient is symptomatic

Question 26

_______________________; - Affect approximately 7% of perimenopausal women - Account for 15% of all breast lumps and typically affects females aged 40-60 years old - May enlarge with hormonal changes of the menstrual cycle **Management?**

Answer 26

**Breast Cysts** Management: - Simple reassurance - May be repeatedly aspirated (Patient will require repeat imaging to ensure no underlying malignancy).

Question 27

_______________________; - Disorganized overgrowth of normal breast tissue - Benign, however, may grow progressively **Management?**

Answer 27

**Harmartoma** Management: Excision

Question 28

**Fat Necorsis** - Causes? - Management?

Answer 28

**Fat Necrosis**: partial necrosis of adipose tissue w/ associated inflammatory response Causes: - Trauma - Surgery - Radiotherapy - Mammogram Management: - Exclude carcinoma - Reassurance

Question 29

**Nipple Discharge Differential** - Multiduct Clear Galactorrhea - Single Duct Clear Galactorrhea - Multicolored Discharge - Bloodstained Discharged

Answer 29

**Multiduct Clear Galactorrhea** - Mechanical stimulation - Post lactational - Stress - Menopause - Menarche - Drugs - Pituitary tumors **Single Duct Clear Galactorrhea** - Papilloma **Multicolored Discharge** - Duct Ectasia - Cysts **Bloodstained Discharged** - Duct Ectasia - Invasive Carcinoma - Pregnancy - Papilloma

Question 30

Causes of Gynaecomastia

Answer 30