Surgery and Reconstruction in Breast Cancer Flashcards Preview

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Flashcards in Surgery and Reconstruction in Breast Cancer Deck (11)
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1
Q

what are the 2 different kinds of breast surgery?

A

breast conservation

  • lumpectomy
  • wide local excision
  • wire guided local excision
  • oncoplastic breast conservation inc therapeutic mammoplasty

mastectomy

  • traditional transverse
  • skin sparing with immediate reconstruction
2
Q

when would a breast conservation be performed?

A

equivalent disease free and overall survival as mastectomy as long as

  • clear margins >1mm
  • breast radiotherapy
3
Q

what neoadjuvant treatment can be used to achieve breast conservation?

A

chemotherapy (standard FEC100 and taxane) +/- herceptin

*aromatase inhibitors more effective than tamoxifen so reserved for post menopausal women

4
Q

what is oncoplastic surgery?

A

oncoplastic - safe oncological (cancer) surgery while avoiding tissue deformity

uses principles of cancer and plastic surgery to reshape breast contours at time of cancer resection

5
Q

what is a mastectomy?

A

removal of all breast tissue

6
Q

what are the options post mastectomy?

A

external prosthesis

reconstruction

  • implant only
  • latissmus dorsi (LD) pedicled flap +/- implant
  • deep inferior epigastric artery perforator (DIEP) free flap
  • inferior gluteal artery perforator (IGAP) free flap
7
Q

what are the two different types of breast reconstruction options?

A

implant based

  • tissue expander
  • ADM / implant
  • de-epithelialised skin / implant
  • LD / implant

autologous

  • pedicled LD flap
  • pedicle TRAM
  • free TRAM
  • DIEP flap
  • S-GAP flap
  • I-Gap flap
8
Q

what is the current method of implant reconstruction?

A

1st: mastectomy and creation of submuscular pocket with expander insertion

clinic visits for expansion 2 weekly

2nd: exchange of expander for permanent implant (although can leave some expanders and remove ports only)

9
Q

what are the advantages of “one stage” implant reconstruction by providing lower pole coverage?

A
better lower pole expansion 
reduce postoperative pain 
improved aesthetic outcome 
permanent implant can be used at 1st operation 
also useful for revisional surgery
10
Q

what axillary treatment options can take place?

A

sentinel node biopsy
axillary clearance
axillary radiotherapy

11
Q

what is herception?

A

human epidermal growth factor receptor 2 monoclonal antibody trastuzamad