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Flashcards in Breast Deck (40)
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1
Q

What is included in breast triple assessment

A

Clinical assessment
Imaging
Biopsy

2
Q

How is each aspect of the breast triple assessment scored

A
1 - normal
2 - benign
3 - intermediate/probably benign
4 - suspicious
5 - malignant
3
Q

What is the main risk factor for breast cancer other than being female

A

Age

4
Q

What is the lifetime risk for developing breast cancer

A

1 in 8

5
Q

Factors that lower the risk of developing breast cancer

A

Increasing parity
Earlier age at first birth
Longer duration of breastfeeding

6
Q

Factors that increase the risk of breast cancer

A
Early menarche
HRT use
Smoking
Alcohol
Nulliparity
Obesity
Radiation
FH
Dense breasts
7
Q

Letters used in assessment for breast cancer

A
P - palpation
M - mammogram
U - USS
B - biopsy (core biopsy)
C - cytology  (FNAC)
8
Q

What is Pagets disease of the nipple

A

Eczema like changes that begin in the nipple then spread out to the areola. Red, itchy, scaly, burning.
It is a signs of breast cancer in the tissue behind the nipple

9
Q

What are the two views taken in mammography

A

MLO - mediolateral oblique

CC - craniocaudal

10
Q

What is the age where you would use USS rather than mammography and why

A

<40 because breasts are more dense (fibroglandular > fat)

11
Q

What is the name of the ligaments you can see on mammograms

A

Coopers ligaments

12
Q

What are the two ways you can obtain a breast biopsy

A

FNAC

Core biopsy

13
Q

What are the subtype of breast cancer B5

A

5a - non-invasive

5b - invasive

14
Q

What information can core biopsy of the breast provide than FNAC can’t

A

Whether it is invasive or not

Receptor status

15
Q

Anatomical margins of the breast

A

2nd - 6th rib
Lateral edge of sternum
Mid-axillary line
Axillary tail extends up into the axilla

16
Q

What are the 3 levels of axillary lymph nodes

A

Level 1 - nodes inferior to pect minor
Level 2 - nodes behind pec minor
Level 3 - nodes above pec minor

17
Q

Skin tethering Vs skin fixation

A

Skin tethering means that the lump is attached to the skin, but can be moved in an arc without moving the skin. If the lump is pulled outside the arc, the skin indents. Skin fixation is where the lump cannot be moved without moving the skin.

18
Q

Most breast cancers occur in which part of the breast

A

Upper outer quadrant

19
Q

When would you perform sentinal node biopsy rather than axillary node clearance

A

If imaging and FNAC/Biopsy of the node is normal then do SNB, whereas if either were abnormal then you do clearance

20
Q

ER positive breast cancers should be treated with which agent

A

Tamoxifen (anti-estrogen)

21
Q

HER2 positive breast cancers should be treated with which agent

A

Herceptin (Trastuzumab - anti-HER2)

22
Q

What are the two most common types of breast cancer

A

Invasive ductal carinoma

Invasive lobular carcinoma

23
Q

What is the goal of adjuvant chemotherapy in breast cancer

A

To eradicate micrometastatic disease

24
Q

Triple negative breast cancer is negative for which receptors

A

ER
PR
HER2

25
Q

What tool can be used to estimate breast cancer survival and estimate the benefits of hormone therapy/chemotherapy

A

PREDICT tool

26
Q

What drug is Herceptin

A

Trastuzumab

27
Q

What are the two main classifications of breast pain

A

Cyclical

Non-cyclical

28
Q

What antibiotic is used to treat infectious lactational mastitis or breast abscess

A

Flucloxacillin

29
Q

If a woman presents with mastitis or breast abscess who isn’t breast feeding what should you think of

A

Inflammatory breast cancer

30
Q

If you can feel what you think is a fibroadenoma what P score would that be

A

P2

31
Q

What age group with suspected fibroadenomas will need biopsy as well to complete the triple assessment

A

Age >25

32
Q

What does popcorn calcification on mammography represent

A

Multiple calcified fibroadenomas in post menopausal women

33
Q

Most common benign breast lump in a woman >50

A

Cyst

34
Q

Microcalcifications on mammogram can indicate what

A

Ductal carcinoma in situ
Previous trauma/surgery
Can be seen in association with cysts/fibroadenomas

35
Q

Follow up for women after DCIS breast cancer treatment

A

Annual clinic appointments

Annual mammogram for 5 years

36
Q

FH referral criteria for breast cancer

A
  • one first-degree female relative diagnosed with breast cancer at younger than age 40 years or
  • one first-degree male relative diagnosed with breast cancer at any age or
  • one first-degree relative with bilateral breast cancer where the first primary was diagnosed at younger than age 50 years or
  • two first-degree relatives, or one first-degree and one second-degree relative, diagnosed with breast cancer at any age or
  • one first-degree or second-degree relative diagnosed with breast cancer at any age and one first-degree or second-degree relative diagnosed with ovarian cancer at any age (one of these should be a first-degree relative) or
  • three first-degree or second-degree relatives diagnosed with breast cancer at any age
37
Q

What are the two genes most commonly mutated in cases of familial breast cancer

A

BRCA1 and BRCA2

38
Q

What are diagnostic and predictive testing in relation to genetic breast cancer screening

A

Diagnostic testing is where somebody affected has genetic testing to pin point a cause

Predictive testing is where relative then have their genes tested for the defect found

39
Q

Siblings of a BRCA1 carrier have what % chance of also being a carrier

A

50%

40
Q

When is breast cancer screening offered

A

Age 50 - 71 every 3 years

In extension areas age 47-73