HY Random
Every structure you're about to injure
Nerves, nodes, and nightmares
Trials that saved arms
Dreaded Dyes
100
If no sentinel node is identified intraoperatively, this axillary procedure should be performed
What is axillary lymph node dissection
100
Sensory branch to the medial arm
intercostal brachial
100
SLNB incision sites can report up to this percentage of wound infection
What is up to 10%
100
According to ACOSOG Z0011, patients with T1–T2 disease, 1–2 positive sentinel nodes, lumpectomy, and whole-breast irradiation do NOT routinely require this procedure
Completion axillary dissection
100
Isosulfan blue or methylene blue should be injected at this time.
What is during prep (~30 minutes before)
200
Isolated tumor cells are defined as nodal metastases measuring this size or smaller and are staged as N0
What is less than and equal to 0.2mm (<200 cells)
200
Rotter nodes are what nodes and are physiological similar to what level?
What are interpectoral lymph nodes. Level 2, NOT ZONE 2.
200
Compared with axillary lymph node dissection, this complication is significantly reduced with sentinel node excision.
What is lymph edema
200
Low- or intermediate-grade tumors ≤2 cm with normal clinical exam and axillary ultrasound define eligibility for this trial evaluating omission of sentinel node surgery
What is the SOUND trial
200
Skin necrosis, pulmonary edema, and serotonin syndrome.
What is methylene blue
300
Micrometastases measure greater than 0.2 mm but less than or equal to this size, and generally do NOT mandate ALND
What is 2mm.
Between 0.2 - 2mm are considered micrometastases
300
What anatomical landmark will guide the placement of your initial incision for a SLNB?
What is the lateral border of the pec major.
300
Rate of motor nerve injury to quote for ALND
<1%
300
This trial demonstrated no improvement in axillary recurrence with ALND compared to nodal irradiation, but significantly higher long-term morbidity
What is the AMAROS trial
300
Carries up to a 1% risk of severe anaphylaxis
What is isosulfan blue
400
These groups of people do or do not warrant SLNB
1. Patients with DCIS undergoing mastectomy or reconstruction
2. T1-T3 invasive cancer, clinical negative, W/O ultrasound
3. T1-T3 w/prior lymph nodes positive now s/p neoadjuvant chemo
What is do require SLNB.
400
This anatomic structure forms the superior border of the axilla
What is the axillary vein
400
ALND and SLNB each carry their own risk of lymph edema. What are the percentages associated that you will quote to patients?
What is 20-50% and 3-8%, respectively
400
Low- or intermediate-grade T1–T2 disease with normal clinical exam and axillary ultrasound defines eligibility for this axillary de-escalation trial
What is the INSEMA trial
400
Used for sentinel node mapping in pregnant patients
what is technetium sulfur
500
Her2+, Inflammatory Breast Cancer, Nodal positive, Triple negative, and size >T3 are all a population that all would be counseled for this treatment
What is neoadjuvant therapy?
Her 2 +
Inflammatory breast
Node positive
Triple negative
Size (T3-T4)
500
Medial pectoral nerve anatomy: pierces pec minor and goes lateral what percentages
60% and 40%
500
This strategy during ALND helps reduce the risk of postoperative lymphedema
What is avoid skeletonizing the axillary vein
500
Established targeted axillary dissection after neoadjuvant chemotherapy, allowing omission of ALND dual tracer used and sentinel and clipped nodes are negative
Z1071, SENTINA
500
When using radioactive tracer, any lymph node with counts greater than this percentage of the hottest node should be removed
what is 10%