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SB82 Breast

SB82 Breast - loosely taken from Fiser's ABSITE review

Breast is formed from this embryonal structure ___________ Ectoderm milk streak
Estrogen is responsible for development of these breast structures ______________ Ducts
Progesterone is responsible for development of this breast structures _____________ Lobules
What hormone synergizes estrogen and progesterone in breast development? ___________ Prolactin
Injury to what structure in breast surgery results in a winged scapula? __________ Long thoracic nerve
What artery brings blood to the serratus anterior muscle? ____________ LATERAL thoracic artery
What nerve innervates the latissimus dorsi? ______________ Thoracodorsal
Which nerve innervates the pectoralis major ONLY? ________________ Lateral pectoral nerve
Where is the intercostobrachial nerve encountered during axillary dissection? Just inferior to the axillary vein
What is the significance of Batson’s plexus? It is comprised of valveless veins that that allow direct metastasis of breast cancer to the spine
What percentage of lymphatic drainage from the breast goes to the axillary nodes? 97%
A patient comes in with primary axillary lymphadenopathy. What is the most common diagnosis? _____________ Lymphoma
What is the significance of Cooper’s ligaments? Suspensory ligaments of the breast that can cause skin dimpling if involved with a cancerous lesion
What is the most common organism in breast abscesses? _________ Staph aureus
A non-lactating woman arrives at your office with a swollen, painful breast. Incisional biopsy confirms infectious mastitis. What are the common causes of her condition? In non-lactating women, the common causes are autoimmune disorders (lupus) and chronic inflammatory diseases (acinomyces, TB, syphilis)
What condition may masquerade as infectious mastitis? ___________ Necrotic cancer
Biopsy of a patient’s breast lesion returns with a pathology report of dilated mammary ducts, inspissated secretions, and marked periductal inflammation. What is the likely diagnosis? ____________ Mammary duct ectasia
What is the characteristic discharge associated with mammary duct ectasia? Creamy
How would you clinically determine if a male patient has gynecomastia? A 2-cm pinch of tissue is present
Neonatal breast enlargement is due to ________________ Circulating maternal estrogens
Polythelia is most likely present in this location ____________ Axilla
Term for ‘accessory breast tissue’ ______________ Polythelia
What findings would you expect to see in a patient with Poland’s syndrome? Hypoplasia of the chest wall, amastia, hypoplastic shoulder, no pectoralis muscle
Workup for mastodynia H+P and bilateral mammogram
Most common cause of cyclic mastodynia ___________ Fibrocystic change
Superficial vein thrombophlebitis of the breast _____________ Mondor’s disease
On a patient’s screening mammogram, you notice a cluster of calcifications. What is the next step? ___________ Excisional biopsy
Excisional biopsy of a cluster of calcifications noted on screening mammography shows regular nuclei without mitoses. What is the diagnosis? ___________ Sclerosing adenosis
What is the most common cause of bloody nipple discharge? ____________ Intraductal papilloma
Treatment of intraductal papilloma ___________ Excision
Most common breast lesion in adolescents and young women _____________ Fibroadenoma
Workup for suspected fibroadenoma in patients younger than 30 versus patients older than 30 Younger than 30 – core needle biopsy. Older than 30 – excisional biopsy
Green nipple discharge is usually due to ________ Fibrocystic change
Bloody nipple discharge is usually due to ____________ Intraductal papilloma
Workup for suspected intraductal papilloma ____________ Galactogram
Serous nipple discharge is usually due to _______________ Cancer
Definition of diffuse papillomatosis Papillomas within multiple ducts of both breasts
Mammogram in diffuse papillomatosis shows this appearance ___________ Swiss cheese appearance
What percentage of patients with diffuse papillomatosis may get breast cancer? _________ 40%
Which is considered a premalignant lesion, DCIS or LCIS? __________ DCIS
What margin do you need for DCIS excision? 2-3 mm
What is the most aggressive subtype of DCIS? ___________ Comedo
At what size DCIS should you be worried about risk for recurrence? > 2.5 cm
What percentage of patient’s with DCIS get cancer if not resected? 40-60%
Treatment for DCIS Simple mastectomy versus lumpectomy and radiation
What percentage of patients with LCIS are at risk of developing breast cancer? _______ 40%
What percentage of patients with LCIS who develop breast cancer will develop ductal adenocarcinoma? 70%
LCIS is primarily found in which population of women, premenopausal or postmenopausal? Premenopausal
What is the risk of having a synchronous breast cancer (in the opposite breast) at the time of diagnosis of LCIS? 5%
Breast cancer screening decreases mortality by _________% Twenty-five
A mass needs to be greater than __________ mm to be detectable by mammography Five
A mammogram is read as BIRAD-3. What is the appropriate action? Short interval follow up with imaging (within 6 months)
A mammogram is read as BIRAD-4. What is the appropriate action? Further immediate imaging vs. biopsy
Nodes located between the pectoralis major and minor muscles _________ Rotter’s nodes
What is the 5-year survival of breast cancer patients with 1-3 lymph nodes on axillary dissection? 60%
A T2 lesion is what size? 2-5 cm
Which genetic mutation is associated with breast AND ovarian cancer? BRCA1
What percentage of breast cancers are negative for both hormone receptors? 10%
Male breast cancers are usually hormone ______________(positive / negative) Positive
Treatment for male breast cancer Modified radical mastectomy
Ductal carcinoma comprises ______________% of all breast cancers 85%
Which type of ductal breast carcinoma is hormone positive? _________ Medullary
Lobular breast carcinoma comprises what percentage of breast cancers? 10%
Absolute contraindications for breast-conserving therapy >2 primary tumors in separate quadrants, persistent positive margins, pregnancy, prior irradiation, diffuse microcalcifications
A patient who has undergone axillary dissection has sudden, early post-op arm swelling. What is the likely diagnosis? ____________ Axillary vein thrombosis
What are the indications for radiation therapy after mastectomy?>4 nodes, skin/chest wall involvement, positive margins, tumor > 5 cm, extracapsular nodal invasion, inflammatory cancer, fixed axillary nodes
Indications for post-operative chemotherapy for breast cancer include everyone except ________ Postmenopausal women with hormone-positive disease – get tamoxifen
A patient presents to your office complaining of a scaly nipple lesion. Biopsy shows Paget cells. What is the likely diagnosis? DCIS or ductal adenocarcinoma
A biopsy of what clinically appears to be a giant fibroadenoma returns with a pathology report of disordered stromal and epithelial elements. How would you determine if this is malignant? Mitoses per high-powered field
A giant fibroadenoma with a pathology report of disordered stromal and epithelial elements is likely ___________________ Cystosarcoma phyllodes
What percentage of Cystosarcoma phyllodes are malignant? 10%
How does Cystosarcoma phyllodes spread? _________ Hematogenously
What is the treatment for Cystosarcoma phyllodes? Wide local excision with negative margins
What is Stewart-Treves syndrome? Lymphangiosarcoma that develops 5-10 years after lymphedema resulting from ALND for breast cancer
Created by: StudyBug82
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