Breast

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  1. How to …. ?

⭕ History taken
⭕ Class by Consultant
⭕ Read Bailey

✅ ⭕

Format

Specific Symptoms

BATMAN … ?

Bleeding PR … ?

Hx of Present Complaint (D-SAC)

  • SOCRATES-P
  • Aetiology (risk factors, family hx)

More exposure to Oestrogen

  • Complications (Local, locoregional and distant spread)

History

Mr. Jamis … ?

Ix and Mx

  • Investigations

Triple Aessessment

  1. Clinical
  2. Radiological

Mammgography views

  • Cranio-caudal
  • Medio laeral

 

USS – BIRADS (Breast Imaging Reporting and data systems)

3. Pathological

FNAC

Core biopsy (Tru Cut)

  • Management

Staging of Breast CA

  • T₂ N₁ M₀ (210) – Early breast Ca, surgical management
  • If above – Advanced breast CA

 

WLE + RT = Mastectomy

Ductal CA In Situ

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Local and Systemic Treatment

Local

  • Breast Conserving Sx – Wide local excision –> Adjuvant Radiotherapy
  • Mastectomy –> Sentinal node biopsy ( RT not indicated )

Radiotherapy improves LOCAL recurrence.

For receptor positive CA 5 yrs of Hormonal therapy to prevent recurrence. Tamoxifen for pre-menopausal and Anastrozole for post-menopausal.

 

Systemic

Oestrogen, Progrestrogen and Her-2 receptors

If Her-2 receptor +, poor prognosis

 

Invasive CA

No place for Adjuvant Hormonal therapy after bilateral mastectomy.

Theory

  • Anatomy
  • Physiology
  • Pathology

 

 

Ix and Mx

 

Theory

  • Anatomy
  • Physiology
  • Pathology