Procedures

Question 1

What is another term for ductography?

Answer 1

Galactography

Question 2

When are ductography’s typically performed?

Answer 2

On patients who present spontaneously with single duct discharge and usually normal mammo

Question 3

Trigger point

Answer 3

location when compressed, results in nipple discharge

Question 4

What are 2 contradictions to perform a ductography?

Answer 4

1. Mastitis
2. Breast abscess

Question 5

What do galactography help to do?

Answer 5

Identify any lesion present within the duct

Question 6

What position is the Pt do perform a ductography?

Answer 6

Supine position with a special lamp and magnify glass

Question 7

What is critical for not to happen with galactography?

Answer 7

No air bubbles be present in the syringe

Question 8

How much contrast is injected with fir a ductography?

Answer 8

0.2-0.4ml

Question 9

Are mammos pictures obtained with ductogrpahy’s?

Answer 9

Yes

Question 10

What must be assumed whenever there is a filled defect with galactography?

Answer 10

Ductal carcinoma must be suspected

Question 11

What kind of discharge form the nipple is most concerning for malignancy?

Answer 11

Bloody nipple discharge

Question 12

What does it mean if the lymph nodes have cancer?

Answer 12

It has metastasize

Question 13

Where do breast lymph vessels drain?

Answer 13

Into the lymph nodes in the axilla

Question 14

What is one of the strongest prognostic indicator in patients with breast carcinoma?

Answer 14

The status of the axillary lymph nodes

Question 15

What is the most important predictor of breast cancer survival?

Answer 15

The status of the lymph nodes

Question 16

What % is decreased from those who have a 5 year survival with positive nodes?

Answer 16

15%

Question 17

Sentinel lymph node

Answer 17

The very first node to receive drainage from the tumour of the breast

Question 18

ALND

Answer 18

Axillary lymph node dissection

Question 19

Axillary lymph node dissection

Answer 19

10-15 nodes were removed and sent to the pathologist

Question 20

What are 4 negative aspects to ALND?

Answer 20

1. Swelling
2. Lymphedema\
3. Chronic pain
4. Numbness

Question 21

Sentinel lymph node biopsy

Answer 21

Can be mapped with radioactive dye that can be measured by a hand held probe called lymphoscintigraphy or by the interstitial injection of a blue dye the stains the lymph tissue a bright blue so it can be seen during surgery and removed

Question 22

How many nodes are typically removed with a sentinel lymph node biopsy?

Answer 22

1-3 nodes

Question 23

What are 6 advantages to a sentinel lymph node biopsy?

Answer 23

1. Less invasive
   - no need for an axillary drain
2. Reduced hospital stay
3. Reduced post-op physical therapy with faster recuperation
4. Reduced dissection and disfigurement
5. Fewer long term post-op complications
6. Potential for more accurate node assessment

Question 24

What is considered the gold standard node procedure for lymph nodes?

Answer 24

Traditional axillary lymph node dissection

Question 25

What situations are sentinel node biopsy contradicted? (8)

Answer 25

1. Patients with lymphatic drainage to the intramammary lymph nodes rather than the axilla 2. Patients who have had radiation therapy or surgery in their breast or axilla 3. Patients with enlarged axillary lymph nodes 4. Patients with metastatic breast cancer to their axillary lymph nodes 5. Patients with previous mastectomy 6. Patients with large tumours - greater than 5cm 7. Patients in whom the primary breast tumour cannot be identified 8. Patients with multicentric breast tumours

Question 26

The sentinel node procedure is not indicative of metastatic disease, what does it locate?

Answer 26

The nodal basin of the axilla

Question 27

Histology

Answer 27

A branch of anatomy that deals with the minute structure of animal and plant tissues as discernible with the microscope

Question 28

Cytology

Answer 28

A branch of biology dealing with the structure, function, multiplication, pathology life history of cells