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Repro 2 Final > The Normal and Abnormal Breast > Flashcards

The Normal and Abnormal Breast Flashcards

1
Q

Where is most of the glandular tissue in the breasts?

A

-upper outer quadrants

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2
Q

What structure is where the duct opens into the nipple?

A

-the sinus!

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3
Q

What hormone is responsible for gorwht of adipose tissue and lactiferous ducts?-

A

estrogen

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4
Q

What hormone is responsible for stimulation of lobular growth and alveolar budding?

A

-progesterone

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5
Q

What are some diagnostic tests for the breast?

A
  • Mammogram
  • ultrasound
  • MRI
  • FNA
  • Corebiopsy
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6
Q

What always gets a biopsy of some kind?

A

-palpable masses

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7
Q

When are mamograms best?

A

-in women over 40

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8
Q

What is the difference between screening and diagnostic mammogram?

A
  • screening: no compaint/concerns

- Diagnostic: if there is a palpable mass or something

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9
Q

What is useful for evaluating inconclusive mamorgram findings and is best for evaluating young women <40

  • and allows to differentiate between cystic versus solid lesions
  • and used for guidance when performing core needle biopsies?
A

Ultrasonography

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10
Q

What is useful in determining solid versus cystic masses?

A
  • FNA
  • if bloody, sent to cytology
  • if clear, it’s fine
  • 22-24 gauge needle
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11
Q

What doe we do if the cyst completely disappears after FNA?

A

-return for clinical breast exam in 3 months

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12
Q

What do we do if the cyst reappears or does not resolve after FNA?

A

-diagnostic mammogram/ultrasound and perform biopsy

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13
Q

What is Core needle biopsy?

A
  • larger 14-16 gauge needle
  • Used to get tissue from larger solid masses for diagnosis
  • 3-6 samples about 2 centimeters long are obtained
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14
Q

What is the only FDA approved tx for mastalgia?

A

-danazol

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15
Q

What is the caveat with danazol?

A
  • bad side effects

- hairy and weight gain

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16
Q

What was the thing that was bolded on the mastalgia tx slide?

A

-properly fitting bra, weight reduction, exercise, decrease caffeine intake, and vitamin E supplementation

17
Q

What is bloody nipple discharge considered until proven otherwise?

A
  • cancer

- could be a benign intraductal papilloma though

18
Q

What are some concerns for malignancy with breast masses?

A
  • > 2cm
  • immobility
  • poorly defined margins
  • firmness
  • skin dimpling
  • bloody nipples
19
Q

What are the 3 categories of benign breast masses?

A
  • non proliferative
  • proliferative without atypia
  • proliferative with atypia
20
Q

What is the most common benign tumor of the femal breast?

A

-fibroadenoma

21
Q

What is adenosis?

A

-lobular growth with increased number of glands

22
Q

What is a galactocele?

A
  • cystic dilation of duct filled with milky fluid
  • occurs near time of lactation
  • secondary infection may produce acute mastitis
  • typically can be needle aspirated
23
Q

What are the nonproliferative breast masses?

A
  • fibrocystic changes
  • cysts
  • fibrosis
  • adenosis
  • lactational adenomas
  • fibroadenomas
  • galactoceles
24
Q

What are the proliferative breast masses without atypia?

A
  • ESCP
  • eptihelial hyperplasia
  • sclerosing adenosis
  • complex sclerosing lesions (radial scar)
  • Papillomas (more common)
25
Q

What are the breast masses with atypia

A
  • LCIS

- DCIS

26
Q

What is both LCIS and DCIS treated?

A

-with excision and then followed with treatment with selective estrogen receptor modulators

27
Q

What are some risk factors for breast cancer?

A
  • older than 50
  • being white
  • 1st degree relatives
  • BRCA1 and BRCA2
28
Q

BRCA1

A
29
Q

BRCA2

A

-about 35 % of early onset breast cancers and much lower risk of ovarian cancer

30
Q

Where do most breast cancers occur?

A
  • in the ducts

- 70-80% are ductal

31
Q

Which kind of breast cancer is most likely to be bilateral?

A

-lobular

32
Q

What receptor would we rather not see in breast cancer?

A
  • HER2/neu

- worse prognosis and is found in 20-30% of invasive cancers

33
Q

How would we treat breast cancer?

A
  • lumpectomy with radiation
  • mastectomy
  • the outcomes are equal so… yeah
34
Q

what are some adjuvant therapies we can use in breast cancer?

A
  • -chemo: kill cancer cells
  • hormonal therapy (tamoxifen): antagonize estrogen
  • aromatase inhibitors
  • trasuzumab: acts on ptn made by Her2/neu
35
Q

What are some side effects of trastuzumab?

A
  • heart failure is the bad one
  • respiratory problems
  • serious allergic reactions
36
Q

What do we do for tx follow up with breast cancer?

A
  • every 3-6 months for first 2 years
  • then, annually after first years
  • most reoccurrences will happen within first 5 years after tx

Repro 2 Final (18 decks)

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