Post Procedures

Question 1

What is really important when taking a complete history before a biopsy?

Answer 1

If they are on blood thinners

Question 2

What are 6 post biopsy complications?

Answer 2

1. Excessive bleeding
2. Hematoma
3. Infection
4. Pneumothorax
5. Vasovagal reaction
6. No diagnosis due to insufficient or inappropriate samples

Question 3

What are 5 post surgical finds?

Answer 3

1. Hematoma
2. Fat necrosis
3. Seroma
4. Scarring and/or skin thickening
5. Breast reconstruction surgery

Question 4

Adjuvant

Answer 4

Assisting in the prevention, amelioration, or cure of disease

Question 5

Neoadjuvant

Answer 5

Is delivery of treatment prior to surgery in order to shrink the cancer and facilitate more complete surgical removal of it

Question 6

What are 2 benefits to neoadjuvant therapy?

Answer 6

1. Allows for a breast conserving surgical technique
2. Leads to same results as adjuvant chemotherapy, however leads to higher rates of breast conserving surgery

Question 7

When does surgery take place after neoadjuvant therapy?

Answer 7

4-6 weeks

Question 8

Tamoxifen

Answer 8

Hormonal agent to help prevent cancer from occurring

Question 9

What do 50% of patients experience following a lumpectomy 4 weeks after surgery?

Answer 9

Seroma

Question 10

What % of patients experience a seroma after 6 weeks following surgery?

Answer 10

25%

Question 11

How do seromas appears on US? (3)

Answer 11

1. Complex, cystic masses within the lumpectomy site
2. Common to have septations
3. Thickened walls
   - with or without mural nodules

Question 12

How long does it take for most seroma collections to resolve?

Answer 12

Within 12 months

Question 13

How long does it take skin thickening to resolve post surgery?

Answer 13

Usually resolve within 2 years

Question 14

What % of patients demonstrate residual skin thickening 2 years following radiation?

Answer 14

20%

Question 15

What are post surgical fluid collections replaced with 6-18 months after surgery?

Answer 15

Scar tissue

Question 16

What can scar tissue create?

Answer 16

Architectural distortion

Question 17

What can scar tissue sometimes be confused with?

Answer 17

Spiculated mass
- be careful

Question 18

When should suspicious scar tissue be looked closer at?

Answer 18

If the area on concern increases on size after 2 years
- cancer recurrence should considered

Question 19

Why should magnification views be done after surgery and before radiation? (2)

Answer 19

1. Looking for residual calcifications
2. New calcifications can happen following fat necrosis