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Flashcards in The Surgical Review- Breast Deck (42)
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1

what are the boundaries of the breast?

sternum medially, latissimus dorsi laterally, clavicle superiorly, inframammary crease inferiorly

2

blood supply of the breast?

1. internal mammary
2. lateral thoracic arteries

3

5 important nerves to identify during mastectomy

1. Lateral pectoral: pectoralis major
2. Medial pectoral: pectoralis minor
3. Long thoracic nn: serratus anterior and subscapularis
4. Thoracodorsal: latissimus dorsi
5. Intercostobrachial: sensory fibers to the skin of axilla, medial upper arm and lateral breast

4

What are the BIRADs scores?

0. incomplete, additional imaging needed
1. negative, routine mammo
2. benign finding, routing mammo
3. probably benign, short term fu
4. suspicious, consider biopsy
5. highly suggestive of malignancy

5

what is mondor's disease?

thrombophlebitis of superficial veins of the anterior chest wall and breast
tx: anti-inflammatories and warm compresses

6

most common cause of bloody nipple discharge?

intraductal papilloma

7

what are the five subtypes of DCIS?

1. Comedo: high grade and necrosis
2. Cribriform
3. Micropapilary
4. Papillary
5. Solid

8

what are 4 other less well known subtypes of invasive breast carcinoma?

1. Tubular
2. Medullary
3. Mucinous
4. Metaplastic

9

what are the major determinants of prognosis in breast cancer?

tumor size and lymph node status

10

what are the most common sites of distant metastasis in breast ca? 5

1. bone
2. lung
3. liver
4. brain
5. spine

11

HER2-neu is associated with what 3 factors of prognosis?

1. Increased rate of metastases
2. Poorer overall survival
3. Refractoriness to chemotherapy

12

what is the function of HER2neu

tyrosine kinase growth factor receptor

13

what is the pathogenesis of peak d'orange in inflammatory breast ca?

dermal lymphatic congestion with tumor cells

14

what is the strongest risk factor for male breast cancer?

klinefelter syndrome

15

how do phyllodes tumors metastases and where to?

hematogenously
to lung, bone, and abdominal viscera

16

what 3 veins are most commonly affected in mondors disease?

1. Lateral thoracic vein
2. thoracoepigastric vein
3. superficial epigastric vein

17

what are the three management options when LCIS is discovered?

1. close surveillance
2. Tamoxifen (shown to reduce breast ca risk)
3. Bilateral total masties w recon

18

what is the difference in breast ca of BRCA 1 vs BRCA2 mutations?

BRCA1 more likely to be poorly differentiated and hormone receptor negative whereas BRCA2 is well differentiated and hormone receptor positive

19

hereditary breast ca accounts for what percentage of all breast cancers?

5-10%

20

what accounts for nearly 40% of male breast cancers?

BRCA2

21

Increased risk family history of breast cancer includes what? (6)

1. At least 3 first or second degree relatives with breast ca at any age
2. 2 first degree relatives with breast ca including one who was diagnosed

22

which type of DCIS is assoc w the worse prognosis?

comedo

23

which type of cancer stains positive for S-100 antigen?

Melanoma

24

which type of invasive breast ca has the most favorable prognosis?

tubular

25

neighborhood calcification is a feature characteristic of what?

LCIS

26

what defines a women at "high risk" for breast cancer?

a women as least 35years of age with a 5yr predicted risk of breast cancer of 1.67% or greater (using the gail model)

27

the primary severe adverse reaction to trastuzumab is?

cardiac toxicity: CHF and decreased LVEF

28

what is the most common type of breast lymphoma?

B cell: diffuse large B cell lymphoma

29

treatment of breast lymphoma?

if low grade/localized: excision
if high grade: CHOP + XRT

30

what is CHOP therapy?

Cyclophosphamide, hydroxydoxorubicin, vincristine, prednisone