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breast questions Flashcards

(44 cards)

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1
Q

What are the 6 borders of the breast?

A 
Superior=clavical
Lateral=latissmis dorsi
Medial=sternum
Inferior=rectus abdominus
Anterior=subcutaneous fat
Posterior=Pec major
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2
Q

What are Cooper’s Ligaments?

A

White suspensory ligaments of the breast

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3
Q

Name of the breast suspensory ligaments?

A

Cooper’s Ligaments

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4
Q

Where and what is areola?

A

Small circular area of pigmented skin surrounding the nipple

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5
Q

Name of the opening of the areola?

A

Nipple

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6
Q

Which lymph nodes receive 3/4 of the breast lymph?

A

Axillary

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7
Q

4 different types of breast cancer?

A
  1. DCIS
  2. Ductal invasive carcinoma
  3. LCIS (lobular carcinoma in situ)
  4. Lobular invasive carcinoma
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8
Q

What does DCIS stand for?

A

Ductal Carcinoma in situ

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9
Q

What does DCIS mean about the carcinoma?

A

It has not invaded past the basement membrane

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10
Q

Which lymph node can breast carcinoma easily spread to?

A

Axillary lymph nodes

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11
Q

Where are Level I lymph nodes

A

Inferior lateral to pec minor muscle

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12
Q

Where are Level II lymph nodes?

A

Deep to the pec minor

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13
Q

Where are Level III lymph nodes?

A

Superior-medial the pec minor muscle

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14
Q

5 types of mastectomies?

A
  1. Radical mastectomy
  2. Modified radical
  3. Simple mastectomy mastectomy
  4. Subcutaneous mastectomy
  5. Lumpectomy
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15
Q

What is removed in a Modified Radical Mastectomy?

A

Simple mastectomy plus removal of Lymph Noes level 1 and 2

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16
Q

What is removed in a Simple Mastectomy?

A

Skin, breast tissue, subcutaneous fat, and cooper’s ligaments

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20
Q

Describe Radical Mastectomy (hint: 3 parts)

A
  1. Simple mastectomy
  2. Removal of pac major and minor
  3. Removal of Lymph Nodes levels I, II, and III
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21
Q

Who gets a Subcutaneous Mastectomy?

22
Q

3 risks of PT with BRCA gene?

Study These Flashcards
A
  1. Breast cancer
  2. Ovarian cancer
  3. Recurrence
23
Q

Normally perform a lymphnode biopsy after mastectomy for DCIS?

Study These Flashcards
A

No. In situ and not invaded past basement membrane.

24
Q

What is Sentinel Node?

Study These Flashcards
A

First node where lymph drains to

25
Q

Purpose of Sentinel Node biopsy?

Study These Flashcards
A

Staging of carcinoma

26
Q

What happens to mapping of the lymphatic drainage after simple mastectomy?

Study These Flashcards
A

Mapping destroyed so sentinel node biopsy not useful

27
Q

Is there a mass with DCIS?

28
How are lymph nodes detected? (hint: 2 things)
1. Technecium-99 | 2. Isosulfan blue dye or methylene blue due
29
Where is isosulfan blue dye injected?
Subareolar/paraareolar area
30
Why is isosulfan blue injecte into the subareolar/paraareolar area?
Where lymph drainage follows and stains the lymphatic map
31
How does Tc-99 detect lymph nodes?
Probe detecting concentration of Tc-99 will emit number around 20,000
32
How long to hold Tc-99 probe on LN?
10 seconds
33
What does Tc-99 emit that the probe picks up?
Gamma rays
34
How to determine which lymph nodes to take out?
All LNs that have 10% of highest number (highest 20,000 take nodes 2000)
35
How many LNs normally removed?
About 20
36
Name of pathology quick test for presence of cancer in LN?
Touch Prep. Done during surgery.
37
What to do it Touch Prep is positive for cancer?
Remove all axillary LNs
38
2 main complications of complete axillary LN removal?
1. Lympheema | 2. Brachial plexus neuropathy
39
Why palpate axilla after sentinel node biopsy?
Find nodes not detected by probe
40
Why would LNs not be detected by probe?
Brease tumor can cause lymphatic blockage and prevent Tc-99 and blue dye from draining into entire breast
41
Med class of breast cancer meds?
Estrogen receptors
42
Which estrogen receptor is better for younger women?
Tamoxifen
43
Which estrogen receptor is better for older women?
Raloxifen
44
What type of inhibitors are preferred in older women?
Aromatase inhibitors
45
Lumpectomy aka?
Breast Conserving Therapy
46
2 CIs to Breast Conserving Therapy?
1. Multicentric disease (cancer located in more than 1 quarant, diffuse microcalcification on mammogram) 2. Prior radiation (due to prior tissue damage)
47
5 relative CIs to Breast Conserving Therapy?
1. CREST syndrome 2. SLE 3. Preggers 4. Large tumor in relation to breast 5. Persistent + margins s/p re-excision

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