外科：一般外（breast）

18 flashcards · Other · by Wanying Koh

1. BRCA1 mutation is related to what kind of breast Ca?

   basal-like breast Ca (BRCA2 not related)

2. staging of inflammatory breast cancer

   T4(d) --- poor prognosis peau d'orange axillary LN meta OP (MRM) + CT + RT

3. staging of supraclavicular LN meta

   N3

4. Breast Ca txt for what patients? 1) tamoxifen 2) aromatase inhibitors steroidal: exemestane nonsteroidal: anastrozole, letrozole 3) LH-RH agonist

   1) premenopausal first line 2) postmenopausal 3) pre/postmenopausal 的： 嚴重乳癌, ER/PR(+), unable to tolerate AEs of other drugs 早期乳癌, post-op, 合併 tamoxifen

5. most commonly used breast reconstruction

   TRAM flap

6. N2M0 staging breast Ca pts post-MRM 還需要做什麼治療

   N2 = LN meta. both chemo & RT needed

7. treatment for triple negative breast Ca pts post-op, with N0M0 staging

   chemo + RT

8. modified radical mastectomy includes ALND of which level LN?

   Level 1, 2 LN

9. skin dimpling -- related to what structure

   Cooper's lig --> 維持乳房形狀。skin dimpling due to tumor invasion of Cooper's lig 變短 把皮膚拉凹

10. carcinoma in situ (DCIS/LCIS) tx

    BCS or MRM no need LN dissection no need adjuvant chemo

11. BCS vs. MRM LT-survival need RT? local recurence rate

    LT-survival - both similar need RT? - BCS yes // MRM only at late stages local recurence rate - BCS higher // MRM lower

12. BCS - leave tumor resection margin 多少

    margin of 1cm

13. HER-2 (1+) can be treated?

    not overexpression of HER-2 --> herceptin 會無效 （overstimulation= HER-2 (3+) )

14. infiltrating ductal ca 多少%

    乳癌分類 non-invasive DCIS 5-10% (癌前病變） LCIS 2-5% invasive infiltrating ductal ca 75-80% infiltrating lobular ca 6-8%

15. anastrozole vs. tamoxifen 用的時機

    anastrozole (aromatase) - post-menopausal tamoxifen - pre-menopausal 都是ER+/PR+

16. Paget disease of breast tx

    mass / radiographic (+) total mastectomy + axillary LN dissection mass / radiographic (-) local resection + ALND + adjuvant RT *濕疹性變化

17. cooper lig invasion causes

    skin retraction of breast not peau'd orange - this is lymphatic drainage obstruction

18. breast ca ER+ PR- can use hormonal therapy?

    still can use hormonal therapy