Benign breast DOs Flashcards

Question

When does Type I gynecomastia occur?

Answer 1

Tanner III-IV genital development

Answer 2

transient small disk-like subareola mass tender nipple pain from rubbing (t-shirts, sports) rarely discharge

Answer 3

resolves spontaneously within months-yrs

Answer 4

Some boys want to check / squeeze to get rid of - ask if they do this.. Raises oxytocin / prolactin --\>galactorrhea. Still, get Prolactin level

Answer 5

Breast nodules beneath areola but also extending beyond the areolar perimeter

Answer 6

* “macromastia” * much more distressing degree of development * Tanner III or greater of female development

Answer 7

incidence 4.5% (of those w/gynecomastia, not overall)

Answer 8

cause idiopathic, must R/O other causes

Answer 9

* very long. Some big ones - * **familial gynecomastia** *ask dad, + progression* * **Klinefelter’s syndrome** *always check testes if gynec*, *e.g., flat m&ms* * **androgen insensitivity** * **thyroid dysfunction** * **cirrhosis of the liver** * **male pseudohermaphroditism** * **Meds!**

Answer 10

* **_Measurement_** of breast size *– N-S, E-W* * breast vs adipose tissue *– second opinion!* * HT, WT, BMI * blood pressure * sexual maturity rating * evaluation of genital and testicular size

Answer 11

* Karyotype and testosterone level (Klinefelter / psuedohermaphroditism) * Prolactin (increased likely tumor) * hCG (u/s, likely mass) * Thyroid fx tests (high T4 low TSH=hyperthyroid) * LH, serum testosterone, estradiol (all normal=idiopathic gynecomastia)

Answer 12

_Management_ * REASSURANCE!!! * Counseling for body image issues * cosmetic surgery *Talk about practical issues – how can change in gym, navigate problem solving like in “shirts and skins” etc*

Answer 13

fibroadenomas are very common. While we need to continue to monitor it, it is nothing we are very worried about. They are not cancer and do not cause cancer. Fibroadenomas are likely caused by sensitivity to estrogen, which is one of the hormones in your body that helps you develop into a woman. If the fibroadenoma becomes larger than 4-6cm, or is very bothersome to you, we could explore excision (cutting it out)

Answer 14

These feel like movable cords in your breast, and are caused by levels are your hormones that are either too high or too low. Because they are related to hormone levels, the pain from them can change during your period (when your hormone levels are changing). These are very normal to get, and while we will continue to monitor them, we are not worried about them causing cancer or anything dangerous. If there is pain you can use heating pads on your breast, take ibuprofen, and make sure you have a bra that fits well (you can go get a bra fitting for free at Victoria’s Secret, etc). We could also look at a birth control pill that might help you with some of the pain/sxs.

Answer 15

I know this is hard for you. A lot of boys have this and many times it goes away on its own. Do you know if your father had this? If so, it might be helpful to ask him...if his went away yours is likely to go away. While we don’t know the exact cause, it is likely caused by an imbalance in estrogen and testosterone in your body. How is this impacting your life -- assess for counseling needs…. Treatment we will watch and wait and hope that this gets smaller as you continue to grow. If it bothers you very severely we can explore removal options through surgery, but that would need to be after some time…

Answer 16

* 1x month * 7-10 days after period ends (not before - may have swelling and tenderness) * looking and feeling - circular motions armpit - clavicle - top of abdomen * Use mirror so you can see your whole chest -- look at size and shape, and skin texture both with arms down and then with arms up * Here you go: https://www.youtube.com/watch?v=yw8Gx2LKWhA

Benign breast DOs Flashcards

(40 cards)