Breast Cancer

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Recall

What is the incidence of breast cancer?
What percentage of women with breast cancer have no known risk factor?
What percentage of all breast cancers occur in women younger than 30 years?
What are the major breast cancer susceptibility genes?
What option exists to decrease the risk of breast cancer in women with BRCA?
What is the most common motivation for medicolegal cases involving the breast?
What is the “TRIAD OF ERROR” for misdiagnosed breast cancer?
What are the history risk factors for breast cancer?
What are physical/anatomic risk factors for breast cancer?
Is “run of the mill” fibrocystic disease a risk factor for breast cancer?
What are the possible symptoms of breast cancer?
Why does skin retraction occur?
What are the signs of breast cancer?
What is the most common site of breast cancer?
What are the different types of invasive breast cancer?
What is the most common type of breast cancer?
What is the differential diagnosis?
Describe the appearance of the edema of the dermis in inflammatory carcinoma of the breast.
What are the screening recommendations for breast cancer:

Breast exam recommendations?
Mammograms?

When is the best time for breast self-exams?
Why is mammography a more useful diagnostic tool in older women than in younger?
What are the radiographic tests for breast cancer?
What is the classic picture of breast cancer on mammogram?
Which option is the best initial test to evaluate a breast mass in a woman <30 years?
What are the methods for obtaining tissue for pathologic examination?
What are the indications for biopsy?
What is the process for performing a biopsy when a nonpalpable mass is seen on mammogram?
What is a needle localization biopsy (NLB)?
What is a mammotome biopsy?
What is obtained first, the mammogram or the biopsy?
What would be suspicious mammographic findings?
What is a “radial scar” seen on mammogram?
What tumor is associated with a radial scar?
What is the “workup” for a breast mass?
How do you proceed if the mass appears to be a cyst?
Is the fluid from a breast cyst sent for cytology?
When do you proceed to open biopsy for a breast cyst?
What is the preoperative staging workup in a patient with breast cancer?
What hormone receptors must be checked for in the biopsy specimen?
What staging system is used for breast cancer?
Describe the staging (simplified):

Stage I
Stage IIA
Stage IIB
Stage IIIA
Stage IIIB
Stage IIIC
Stage IV

What are the sites of metastases?
What are the major treatments of breast cancer?
What are the indications for radiation therapy after a modified radical mastectomy?
What breast carcinomas are candidates for lumpectomy and radiation (breast-conserving therapy)?
What approach may allow a patient with stage IIIA cancer to have breast-conserving surgery?
What is the treatment of inflammatory carcinoma of the breast?
What is “lumpectomy and radiation”?
What are other contraindications to lumpectomy and radiation?
What is a modified radical mastectomy?
Where are the drains placed with an MRM?
When should the drains be removed?
How can the long thoracic and thoracodorsal nerves be identified during an axillary dissection?
What is a sentinel node biopsy?
How is the sentinel LN found?
What follows a positive sentinel node biopsy?
What is now considered the standard of care for LN evaluation in women with T1 or T2 tumors (stages I and IIA) and clinically negative axillaryLNs?
What do you do with a mammotome biopsy that returns as “atypical hyperplasia”?
How does tamoxifen work?
What is the treatment for local recurrence in breast after lumpectomy and radiation?
Can tamoxifen prevent breast cancer?
What are common options for breast reconstruction?
What is a TRAM flap?
What are side effects of tamoxifen?
Give the common adjuvant therapy for the following patients with breast cancer. (These are rough guidelines; check for current guidelines, as they are always changing.) (ER = estrogen receptor):

Premenopausal, node +, ER −
Premenopausal, node +, ER −
Premenopausal, node −, ER +
Postmenopausal, node +, ER +
Postmenopausal, node +, ER −