Breas Clinical Correlation

Question 1

WHat is the lifetime risk for developing breast cancer in US women?

Answer 1

1 in 8

Question 2

THe majority of women who develop BCa are over age __ and have __ obvious risk factors?

Answer 2

over age 50 and have no obvious risk factors

Question 3

What are the risk factors for breast CA?

Answer 3

1. increasing age
2. gender (female much more likely)
3. race (caucasion more than african americans)
4. prior hx of BCa
5. Fmily Hx of 1st degree relative with BCa
6. Prolonged/Uninterrupted exposure to estrogen (birth control, delay pregnancy, hormone replacement, early menarche with later menopause onset)

Question 4

WHen do you use BRCA1 and 2 testing?

Answer 4

when there is a family history of breast or ovarian Ca on both the maternal and paternal sides

it’s a really expensive test, but if you have it your risk of breast cancer is 65%

Question 5

What are the latest screening guidelines from the USPSTF?

Answer 5

biennial screening mammography for women 50 to 74 yoa.

recommends against teaching breast self examination

Question 6

Besides mamography, what are two ways to check for BCa?

Answer 6

clinical breast examination

MRI

Question 7

Who should be clinical breast exams and how offten?

Answer 7

every 3 years for women age 20-39

annually for women 40 and over

Question 8

What causes peu d’orange?

Answer 8

it’s thickened skin with enlarged pores due to lymphatic blockage

Question 9

What is Paget’s Disease of the Nipple?

Answer 9

uncommon form of breast CA that starts as a scaly, ecsemalike lesion that may weep, crust or erode

Question 10

Describe cyclic mastalgia.

Describe non-cyclic mastalgia.

Answer 10

cyclic: bilateral, diffuse, radiates to axilla, related to menstruation

non-cyclic: unilateral and/or focal - constant

Question 11

What kind of mastaglia merits evaluation with diagnostic imaging?

Answer 11

focal breast pain

Question 12

What kind of drugs can cause mastalgia?

Answer 12

hormone therapy

psychotropics liks SSRI and Haldol

Cardiovascular like spironolactone and digoxin

contraceptives

Question 13

Is nippel discarge usually a sign of cancer?

Answer 13

no - benign in 97% of cases

Question 14

Describe physiological discharge

Answer 14

it’s bilateral, involves multiple dicts and associated with nipple stimulation or breast compression

bilateral milky white discharge

Question 15

What is galactorrhea?

Answer 15

physiological discharge that ocurs due to an endocrine issue

Question 16

What are some drugs that can cause physiological discharge?

Answer 16

antihypertensives, GI agents, hormones, opiates, psychotropic agents

Question 17

Describe pathological discharge.

Answer 17

it’s spontaneous, unilateral, bloody, serous, clear, or associated with a mass

caused by ductal carcinoma or infection

workup with mammography or subareolar ultrasound

Question 18

What are characteristics of a benign breast mass?

Answer 18

discrete margins, no skin changes, smoother, soft to firm, mobile

Question 19

What are some characteristics of malignant breast masses?

Answer 19

hard, immobile, fixed to surrounding tissue and poorly defined margins

Question 20

What are the three most common breast masses?

Answer 20

Fibradenoma

cysts

breast cancer

Question 21

What are three ways you can biopsy a breast mass?

Answer 21

fine needle aspiration

US-guided core needle biopsy

excisional biopsy

Question 22

What should you do with a discrete mass when the mamogram is negative?

Answer 22

STILL DO A BIOPSY