Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro > Lecture 12: Breast Disorders > Flashcards

Lecture 12: Breast Disorders Flashcards

1
Q

When should the CBE be performed? (what phase)

A

Follicular phase

- one week after menses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 causes of Cyclic breast pain (mastalgia)

A
  1. Hormonal changes w/menstrual cycle
  2. OCPs
  3. Fibrocystic breast Dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What phase/days of the menstrual cycle is a/w Cyclic breast pain

A

Luteal phase

day 14-28

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Large, pendulous breasts  
Mastitis 
BCA (inflammatory) 
Poorly-fitting bra
Pregnancy 
Ductal ectasia
A

Causes of Non-cyclic breast pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does extramammary mean?

A

pain referred from source outside breast (chest wall)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Tx for mastalgia if exam is normal and pain is cyclic?

Meds for pain?

A

reassurance (+/- adjust OCP)

support/sports bra, wt loss

Pain meds: NSAIDs, acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Med Tx for Severe Sxs of mastalgia?

A

Danazol, Tamoxifen, or Bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When is mastitis MC,

normally d/t?

A

in lactating women

d/t nipple trauma (primigravida)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Main Sx of Mastitis?

Otehers?

A

Main = UNILATERAL BREAST PAIN (esp in 1 quad)

Others: breast swelling, warmth, tenderness; nipple d/c

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC pathogenic cause of mastitis

A

Staph Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should ABX tx for mastitis be started?

What is main ABX?

Pt edu for mothers while taking ABX?

A

Sxs lasting > 12-24hrs

Dicloxacillin

Mothers CAN continue to nurse/pump while on ABX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

3 Nipple D/c Characteristics that are likely benign?

A

Nipple d/c that is:

  1. Bilateral
  2. Milky/clear
  3. Multiductal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q 
Nipple D/c Characteristics: 
Spontaneous 
Unilateral 
Uniductal 
Bloody, straw colored, or clear 
Stains clothes 
Persistent
A

Malignant nipple d/c characteristics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management for Physiologic nipple discharge w/no breast stimulation?

A

f/u in 2-3 mo

+/- endo referral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is next step if find malignant nipple d/c, abn findings on US/mammo, or no resolution of Sxs after modifications in meds/lifestyle?

A

Refer to nipple specialist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

are most breast masses/tumors benign or malig?

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the MC presenting Sx in pts w/ BCA?

A

Breast mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What type of Dx test/Bx used for breat cysts?

A

FNA w/Bx

also used for low probability CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is problem w/FNA Bx

A

Skill depedent–> High amt false negatives and non-Dx samples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Other Bx methods other than FNA

What type of Bx is specifically used for Paget’s Dz

A
  1. CNB (core needle Bx)
  2. Incisional Bx
  3. Excisional Bx
  4. Punch Bx (Paget’s dz)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What type of Bx is for a larger tissue specimen, uses only LA and is US guided

A

CNB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can an US determine for breast masses

when is US 1st line Dx test?

A

whether mass is cystic or solid

1st line in women < 30 w/focal breast Sxs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What dx test used for SCREENING women w/no sxs?

A

Mammogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When is SURVEILLANCE mammo used?

A

F/u in pts w/ Hx of BCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When is MRI used to evaluate breast masses?

A
  1. screening for high risk women
  2. assess silicone implants
  3. eval suspicious findings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

At what BIRADS categ is Bx recommended

A

Categ 4 or 5 –> Bx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

At what BIRADS categ is the mass definitely malignant

A

Categ 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

in pts < 30:
1. w/no mass on CBE what is next step?

  1. w/w/indeterminate mass on CBE
  2. suspicious mass

what is next step?

in pts > 30:
what is the only difference in next step?

A
  1. repeat exam in 2-3 mo
  2. US
  3. Dx mammo + directed US w/Bx (FNA)

pts > 30: indeterminate exam –> Dx mammo +/- directed US

29
Q

What 3 types of breast tumors are benign?

A
  1. Simple cyst
  2. Fibroadenoma
  3. Fibrocystic changes
30
Q

What 3 types of findings indicate hyperplasia w/out atypia (not cancerous)

A
  1. Epithelial hyperplasia
  2. Intraductal Papilloma
  3. Sclerosing adenosis
31
Q

What are breast cysts influenced by?

A

hormonal fluctuations

(lobular dev/involution, menses

32
Q

Difference b/t simple and complex cysts?

When should a mammo be performed

A

Simple

  • ONLY FLUID
  • benign

Complex

  • Fluid + SOLID
  • Small risk of malig

mammo: > 30 or complex cyst

33
Q

Tx for simple cyst

A

Aspirate w/FNA

observe 2-3 mos, selfi limited (will resolve on own)

34
Q

Tx for complex cyst

intervention depends on?

A

Must be Bx

surgical intervention based on pathology

35
Q

What is Fibrocystic Breast Dz & what is it d/t?

A

fluid filled breast d/t exaggerated response to hormones (progesterone & estrogen)

  • menstrual hormone changes
36
Q

Sxs of Fibrocystic Breast Dz?

What is not seen in this dz?

A
  1. bilateral cyclic breast pain/tenderness
  2. multiple, mobile, well demarcated lumps
  3. breast size incr/decr w/menstrual hormonal changes

usu no axillary involvement or nipple d/c

37
Q

What is typical dx tool?

What is seen w/Dx FNA

A

US (mammo if >30)

FNA –> straw colored fluid

38
Q

When can FNA fluid removal be performed for Fibrocystic Breast Dz?

A

if pt is symptomatic

39
Q

Most Fibrocystic Breast lumps resolve on own what can be done to manage Sxs?

A

Diet → Low fat, Avoid: caffeine, coffee, soda, chocolate, ETOH

Manage contraception (stop, less estrogen) & HRT

Supportive bra

40
Q

What is a fibroadenoma?

makeup?

A

BENIGN, SOLID TUMOR

makeup: glandular + fibrous tissue (collagen)

41
Q

Smooth, well-defined/circumscribed, NT, rubbery, mobile mass

A

Fibroadenoma

42
Q

How does the size of Fibroadenoma change over time?

A

Gradually incr over time

  • may incr w/preg or estrogen therapy
  • decr after menopause

*doesnt change w/menses

43
Q

Differences b/t fibrocystic breast dz and fibroadenoma?

A

Fibrocystic breast dz

  • fluid filled
  • size change w/menses

Fibroadenoma

  • solid tumor
  • doesnt change w/menses
44
Q

Tx for most fibroadenoma?

A

Observation → most resorb w/time

- Short-term f/u w/ repeat US or CBE

45
Q

MC type of BCA

A

Ductal carcinoma (infiltrative/invasive)

46
Q

2 types of NON-invasive BCA (hyperplasia w/atypia)

A
  1. DCIS (ductal carcinoma in situ)

2. LCIS (lobular carcinoma in situ)

47
Q

2 types invasive BCA

Which one a/w lymphatic mets (esp axillary)

A
  1. Ductal carcinoma→ a/w lymphatic METS (esp axillary)

2. Lobular carcinoma

48
Q

What is the biggest risk factor for BCA?

A

AGE

49
Q

What ethnicity is at very high risk for having BRCA 1/2 mutation?

A

Ashkenazi Jewish women

50
Q

How is estrogen exposure linked to BCA?

A

more/longer estrogen exp = incr risk

  • early menarche
  • late menopause
  • late age 1st pregnancy
  • HRT, OCPs
51
Q

MC location for BCA

A

Upper outer qudarant

52
Q

Main Sxs of BCA

A

Single, NT, firm/fixed/immobile mass

53
Q
  1. Unilateral nipple d/c
  2. Dimpling (if Cooper’s lig involved)
  3. Breast pain
  4. Skin thickening
  5. Nipple inversion
  6. Changes in breast size/contour
  7. Skin discoloration,ulceration, redness, retraction
A

Sxs of BCA

54
Q

What is Inflammatory BCA d/t?

A

lymphatic invasion of tumor cells

55
Q

Main sign w/Inflammatory BCA?

what is it d/t?

A

Peau de orange appearance of breast

d/t lympahtic obstruction

note: a/w poor prognosis

56
Q

Main sign w/Paget’s Dx?

A

Chronic eczematous rash of nipple and areola

may ooze

57
Q

Difference b/t Inflammatory BCA and Pagets Dz

A

Inflammatory BCA
- lump uncommon

Pagets Dz
- lump common

58
Q

What is seen on mammo that is highly suspicious for BCA?

A

microcalcifications & spiculated masses

59
Q

What is considered breast conserving therapy?

A

Lumpectomy

60
Q

Which type of mastectomy spares pect muscles and axillary content?

A

Simple/total mastectomy

61
Q

Which type of mastectomy removes everything (breast, overlying skin, pectoralis major and minor, and entire axillary contents)?

A

Radical mastectomy

62
Q

What types of CA can hormonal therapy tx?

2 Types of hormonal tx?

A

Txs estrogen/progesterone-receptor (+) CA and HER2 (+) CA

  1. SERM (selective estrogen rec modulator)
  2. Monoclonal Ab Tx
63
Q

SERM drugs?

note: can also be used for BCA prevention in high risk pts

A
  1. Tamoxifen
  2. Aromatase inhibitors
    (Letrozole, Anastrozole)
64
Q

Risk w/Tamoxifen?

type of drug/MOA?

A

endometrial CA, DVT

anti-estrogen: blocks it from binding to rec

65
Q

when are aromatase inhibitors helpful?

MOA?

A

AI useful in post menopausal woemn

MOA: reduces estrogen production

66
Q

Monoclonal Ab Tx drug?

used for what types of CA?

A

Trastuzumab/herceptin

for CA w/HER2 (+)

67
Q

Tx for early stage CA

A

Lumpectomy or mastectomy + radiation

Evaluation of axillary nodes - look for METs

68
Q

what LN impacted 1st by BCA

A

sentinel nodes

Repro (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions