Breast - Wootton Flashcards
Why is breast cancer so dangerous?
Tons of blood and lymphatic supply going to and from the breast – easy to metastasize
In breast, role of estrogen vs progesterone
Estrogen - Growth of fat and lactiferous ducts
Progesterone - Growth of lobules and alveolar budding
2 most common breast complaints
Pain, mass
Mammography is best in who?
2 reasons for mammography
Mammography can detect a mass ___ years before palpation
Women 40+
Screening (routine) or diagnostic (lump)
2 years
Guidelines for Mammogram
Guidelines for Clinical breast exam
Every year after 40 (earlier if FHx)
Every 1-3 years after 20, every year after 40
Breast ultrasound is generally used for what?
Best for who?
DIAGNOSTIC testing (mass)
YOUNGER than 40
2 benefits to ultrasound
Often used for what?
- Allows to differentiate cystic from solid
- Good in dense breast tissue (young)
Used for guidance for core needle biopsies
Cystic from solid mass on ultrasound
Cyst = BLACK inside Solid = fuzzy inside
Uses for MRI (4)
- Adjunct to diagnostic mammography
- Post-cancer diagnosis
- Implants (other screenings difficult)
- High risk patients
Core needle biopsy vs. Fine needle biopsy
Core = tissue Fine = liquid
Fine needle aspiration shows bloody fluid. Do what?
Clear fluid?
Send for cytology, get pt mammography/ultrasound
Nothing further
After biopsy, follow up? (Disappear vs. not)
3 months if it disappears
Diagnostic imaging if doesn’t disappear
Causes of non-cyclic breast pain
- Tumors
- Mastitis
- Cysts
- Medications
Causes of extramammary breast pain
Chest wall trauma, shingles, fibromyalgia
Treatment for benign breast pain (drugs vs. not)
- Danazol - lots of side effects
- SERMs, OCPs (cyclical), Depo
- Proper bra, lose weight, exercise, lower caffeine, Vitamin E supplementation
