Breast and Axilla

Question 1

What is Galactorrhea

Answer 1

the inappropriate discharge of milk-containing fluid, which is abnormal if it occurs 6 or more months after childbirth or cessation of breast feeding

Question 2

Risk factors for breast cancer

Answer 2

affected mother or sister, biopsy showing atypical hyperplasia, increasing age, early menarche, late menopause, late or no pregnancies, and previous radiation to the chest wall

Question 3

Redness of the breast

Answer 3

local infection or inflammatory carcinoma

Question 4

Flattening of the breast

Answer 4

If it is normally convex, flattening suggests cancer

Question 5

Asymmetry of directions in which nipples point

Answer 5

underlying cancer

Question 6

Paget’s disease of the breast

Answer 6

Paget’s disease of the breastRash or ulceration of the nipples

Question 7

Nipple retractions

Answer 7

Recent or fixed flattening or depression of the nipple`

Question 8

Dimpling or retraction of the breasts in the “arms over head position”

Answer 8

underlying cancer. When a cancer or its associated fibrous strands are attached to both the skin and the fascia overlying the pectoral muscles, pectoral contraction can draw the skin inward, causing dimpling

Question 9

Dimpling or retraction of the breasts in the “hands pressed against hips” position

Answer 9

may be associated with benign lesions such as post-traumatic fat necrosis or mammary duct ectasia, but they must always be further evaluated

Question 10

Retraction of the nipple and areola in the “leaning Forward” position

Answer 10

underlying cancer. This position may reveal an asymmetry of the breast or nipple not otherwise visible

Question 11

Mass attached to the ribs and intercostal muscles

Answer 11

A mobile mass that becomes fixed when the arm relaxes

Question 12

mass attached to the pectoral fascia

Answer 12

A mobile mass that is fixed when the hand is pressed against the hip

Question 13

thickening of the nipple and loss of elasticity

Answer 13

underlying cancer

Question 14

Gynecomastia

Answer 14

firm disc of glandular enlargement that arises from an imbalance of estrogen and androgens, sometimes drug related. A hard, irregular, eccentric, or ulcerating nodule suggests breast cancer

Question 15

Hidradenitis suppurativa

Answer 15

sweat gland infection in the axilla

Question 16

Acanthosis nigricans

Answer 16

deeply pigmented, velvety axillary skin in the axilla - one form is associated with internal malignancy

Question 17

Enlarged axillary nodes

Answer 17

may result from infection of the hand or arm, recent immunizations or skin tests in the arm, or generalized lymphadenopathy. Check the epitrochlear nodes and other groups of lymph nodes.

Question 18

In the axilla. Nodes > or = to 1cm and fir or hard, matted together, or fixed to the skin or to underlying tissues

Answer 18

malignancy

Question 19

nonpuerperal galactorrhea

Answer 19

milky discharge unrelated to a prior pregnancy and lactation. Causes include hypothyroidism, pituitary prolactinoma, and drugs that are dopamine agonists, including many psychotropic agents and phenothiazines

Question 20

Spontaneous unilateral bloody discharges from one or two ducts

Answer 20

need further evaluation for intraductal papilloma, ductal carcinoma in situ, or Paget’s disease of the breast

Question 21

benign mass of the breastclear, serous, green, black, or nonbloody discharges that are multiductal

Answer 21

usually benign mass of the breast

Question 22

masses, nodularity, and change in color or inflammation, especially incision line

Answer 22

suggest recurrence of breast cancer