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PHASE 3A > WOMEN'S HEALTH - BREAST > Flashcards

WOMEN'S HEALTH - BREAST Flashcards

(68 cards)

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1
Q

define carcinoma

A

cancer that begins in the skin or tissues that line/cover internal organs

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2
Q

6 types of breast cancer

A
  1. ductal carcinoma in situ (DCIS)
  2. lobular carcinoma in situ (LCIS)
  3. invasive ductal carcinoma (NST)
  4. invasive lobular carcinoma (ILC)
  5. inflammatory breast cancer
  6. Paget’s disease of the nipple
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3
Q

what is the most common BC type?

A

invasive ductal carcinoma

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4
Q

what is DCIS? prognosis?

A

precancerous/cancerous epithelial cells of the breast ducts, localised to that area

good prognosis if fully excised/adjuvant tx used

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5
Q

what is LCIS? who does it commonly present in?

A

precancerous condition typically occurring in postmenopausal women

often asymptomatic

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6
Q

where does invasive ductal carcinoma originate?

A

in cells from breast ducts

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7
Q

define invasive

A

cancer that’s spread beyond the layer of tissue in which it developed and is growing into surrounding healthy tissue

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8
Q

what does inflammatory breast cancer present similarly to? prognosis?

A

presents similarly to breast abscess/mastitis BUT won’t respond to abx

worse prognosis than other BCs

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9
Q

which women are those considered ‘high risk’ and so can receive annual BC screening? (from what age)?

A

from age 30 if..

  1. 1st degree relative with BC under 40
  2. 1st degree male relative with BC
  3. 1st degree relative with bilateral BC, first diagnosed under 50
  4. two 1st degree relatives with BC
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10
Q

presentation of inflammatory BC

A
  • peau d’orange
  • inversion
  • warm, tender breast
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11
Q

presentation of Paget’s disease of the nipple

A
  • scaly
  • red
  • dry
  • eczema-like
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12
Q

what are the 4 NICE criteria for a two week wait referral for BC?

A
  1. unexplained breast lump in women >30
  2. unilateral nipple change in patients >50
  3. unexplained axilla lump in >30
  4. skin changes suggestive of BC
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13
Q

what referral type should be considered in women under 30 presenting with an unexplained breast lump

A

non-urgent referral

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14
Q

BC imaging assessment choice in women <40

A

USS

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15
Q

BC imaging assessment choice in women >40

A

mammogram

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16
Q

once a pt is diagnosed with BC following the triple assessment, what investigations should be offered? (2)

A
  1. USS of axilla
  2. ultrasound-guided biopsy of any abnormal nodes
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17
Q

what biopsy can be performed during BC surgery to assess for spread of cancer?

A

sentinel lymph node biopsy (biopsy of first lymph node to which cancer cells are likely to spread to)

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18
Q

surgical management for women with BC who are sentinel node +ve

A

axillary surgery

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19
Q

what reconstructive surgery options are available after breast-conserving surgery?

A
  1. partial reconstruction

OR

  1. reduction and reshaping
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20
Q

what reconstructive surgery options are available after mastectomy? (2)

A
  1. breast implants
  2. flap reconstruction
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21
Q

breast implants
a) advantages
b) disadvantages
c) SEs

A

a) simple, acceptable appearance
b) feels less natural, cold, less mobile, static
c) scar tissue distorting implant, leakage, breast pain, infection, sensation changes, implant position changing

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22
Q

what is there a risk of if the rectus abdominus muscle is used in breast reconstruction?

A

abdominal hernia

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23
Q

chemo uses alongside BC surgery
a) neoadjuvant
b) adjuvant

A

a) pre surgery to shrink tumour

b) post-surgery to prevent recurrence

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24
Q

which BC receptor type is hormonal tx indicated in?

what are the options in pre and postmenopausal women?

A

oestrogen receptor +ve

tamoxifen if premeno

anastrozole if postmeno

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25
which BC receptor type is targeted tx indicated in? what are the options?
for HER2 +ve cancer trastuzumab, pertuzumab, neratinib
26
when is radiotherapy used in BC? what are some SEs?
usually in pts who have had breast-conserving surgery to reduce risk of recurrence SEs = fatigue, local skin and tissue irritation/swelling, fibrosis, shrinking of breast tissue
27
surgical tx for: a) carcinoma in situ b) invasive carcinoma c) Paget's
a) wide local excision or mastectomy b) wide local excision or chemo, consider chemo if later stage c) central excision (nipple and areola) or mastectomy
28
what are fibroadenomas and who are they common in
common benign tumours of stromal/epithelial breast duct tissue common between 20-40yo
29
what do fibroadenomas respond to? therefore when do they tend to regress?
respond to oestrogen and progesterone... regress after menopause
30
typical presentation of a fibroadenoma
mobile, small, firm breast lump painless well-defined round up to 3cm
31
a) typical management of fibroadenoma b) what if >3cm/painful/worried about malignancy?
a) doesn't need removal b) surgical excision
32
what is the most common cause of breast lumps?
breast cyst
33
what is a breast cyst and when do they most commonly occur?
benign, individual fluid-filled lumps perimenpause - 30-50
34
presentation of a breast cyst
1. smooth, well-defined borders, mobile 2. painful 3. fluctuate in size over menstrual cycle
35
investigations for breast cyst
exclude cancer - mammogram or USS then biopsy
36
fine needle aspiration of a breast cyst - what colour should it be?
straw coloured
37
what should be done if fine needle aspiration of a breast cyst is 'straw-coloured' and not bloody?
no further testing or tx required
38
management of breast cyst if it persistently refills/is bloody after fine needle aspiration
biopsy/excise
39
which benign breast lump puts women at a slightly higher risk of BC
breast cyst
40
what is fat necrosis?
benign breasts ump formed by localised degeneration and scarring of fat tissue
41
RFs for fat necrosis breast lump
1. obesity 2. trauma 3. radiotherapy 4. surgery
42
presentation of fat necrosis breast lump
1. painless, firm, irregular 2. may be skin dimpling/nipple inversion
43
investigations for fat necrosis breast lump and which is diagnostic
1. USS/mammogram (may look similar to BC) 2. fine needle aspiration/core biopsy and histology is diagnostic
44
management of breast lump caused by fat necrosis
conservative - resolves spontaneously over time IF sx persist, surgical excision
45
what is a lipoma?
benign tumours of fat (adipose) tissue in any area of body > can be in breast
46
presentation of lipoma of the breast
soft, painless, mobile, NO skin changes
47
management of a breast lipoma
conservative and reassurance
48
what is a galactocele?
breast-milk-filled cysts in the breast
49
which women may get galactoceles?
lactating women, normally after stopping breastfeeding
50
cause of galactoceles
lactiferous duct is blocked > prevents gland from draining milk > milk builds up
51
signs and symptoms of a galactocele
in a woman who has recently stopped breastfeeding... - firm, painless lump - under areola
52
management of a galactocele what if gets infected?
normally resolves without tx if infected - abx
53
what is a duct/breast papilloma?
papilloma = growth (like wart) can grow inside the ducts of the breast, often near the nipple
54
what age are duct/breast papillomas common in?
35-55yo
55
signs and symptoms of a breast/duct papilloma
1. clear/blood-stained discharge from nipple (normally from single duct) 2. breast lump IF duct large enough pain and discomfort not common
56
diagnostic investigation for a duct/breast papilloma
ductogram
57
management of a duct/breast papilloma if a) cells normal under microscope b) cells abnormal under microscope
REMOVAL a) vacuum assisted excision (VAE) b) surgical excision
58
which BC types can duct/breast papillomas rarely be associated with?
DCIS/invasive papillary cancer
59
what is duct ectasia?
dilatation and shortening of the terminal breast ducts within 3cm of the nipple
60
RF for duct ectasia
increased age
61
presentation of duct ectasia
- nipple retraction - creamy nipple discharge
62
management of duct ectasia (troublesome discharge) if a) young b) old
a) microdochectomy b) total duct excision
63
who is typically affected by periductal mastitis?
young women, smokers
64
how does periductal mastitis present?
recurrent periareolar/subareolar infections
65
what does Paget's disease of the nipple indicate?
underlying breast malignancy
66
which BC is Paget's disease of the nipple most commonly associated with?
invasive carcinoma
67
investigations for Paget's disease of the nipple (2)
1. mammography/USS 2. punch biopsy
68
marker for BC monitoring
CA153

PHASE 3A (18 decks)

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