breast

Question 1

Q: What is the typical size and shape of the breast?

Answer 1

A: The breast is symmetric and reaches normal size between 16-19 years.

Question 2

Q: What is the anatomical location of the breast?

Answer 2

A: It is located between the 2nd and 6th ribs, and between the sternum and mid-axillary line.

Question 3

Q: What are the external features of the breast?

Answer 3

A: The nipple and areola, along with superficial skin.

Question 4

Q: How many lobes does the breast contain?

Answer 4

A: The breast is divided into 15-20 lobes.

Question 5

Q: What structure supports the breast lobes?

Answer 5

A: The lobes are embedded in stroma.

Question 6

Q: When do true secretory alveoli develop in the breast?

Answer 6

A: They develop during pregnancy and lactation.

Question 7

Q: What hormones influence the development of secretory alveoli in the breast?

Answer 7

A: Oestrogen, progesterone, and prolactin.

Question 8

Q: What is the retromammary space?

Answer 8

A: It is the space between the breast and the deep fascia on the pectoral muscle.

Question 9

Q: What is the function of the retromammary space?

Answer 9

A: It allows the breast to move freely.

Question 10

Q: What is another term for the retromammary space?

Answer 10

A: It is sometimes referred to as a bursa.

Question 11

Q: What is the effect of estrogen on the breast?

Answer 11

A: Estrogen promotes ductal proliferation.

Question 12

Q: What is the role of progesterone in breast development?

Answer 12

A: Progesterone promotes glandular proliferation.

Question 13

Q: What is the function of prolactin in the breast?

Answer 13

A: Prolactin stimulates milk secretion.

Question 14

Q: What are the ligaments of Cooper?

Answer 14

A: They are bands of connective tissue that anchor the breast to the overlying skin and underlying pectoral fascia.

Question 15

Q: How can cancer affect the ligaments of Cooper?

Answer 15

A: Malignant cells may invade these ligaments, causing dimpling of the skin or attachment of the growth to the skin.

Question 16

Q: What happens when cancer grows along the ligament of Cooper?

Answer 16

A: The breast can become fixed to the pectoralis major, preventing movement along the long axis of the muscle.

Question 17

Q: What visual change may occur due to the invasion of the ligaments of Cooper by cancer?

Answer 17

A: Dimpling of the skin may occur.

Question 18

Q: What artery supplies blood to the lateral aspect of the breast?

Answer 18

A: The lateral thoracic artery, from the 2nd part of the axillary artery.

Question 19

Q: Which arteries provide perforating cutaneous branches to the breast?

Answer 19

A: The internal mammary artery to the 2nd, 3rd, and 4th intercostal spaces.

Question 20

Q: What branches of the intercostal arteries supply the breast?

Answer 20

A: The lateral branches of the 2nd, 3rd, and 4th intercostal arteries.

Question 21

Q: Which artery provides pectoral branches to the breast?

Answer 21

A: The thoracoacromial artery.

Question 22

Q: What defines Level I lymph nodes in the axilla?

Answer 22

A: They are located below and lateral to the pectoralis minor muscle—anterior, lateral, and posterior.

Question 23

Q: Where are Level II lymph nodes located?

Answer 23

A: They are found behind the pectoralis minor muscle—central.

Question 24

Q: What characterizes Level III lymph nodes in the axilla?

Answer 24

A: They are above and medial to the pectoralis minor muscle—apical.

Question 25

Q: What is the prognosis for carcinoma breast when spread is restricted to Level I nodes?

Answer 25

A: It carries a better prognosis.

Question 26

Q: What is the prognosis when carcinoma breast spreads to Level II nodes?

Answer 26

A: It has a poor prognosis.

Question 27

Q: What does spread to Level III nodes indicate in breast carcinoma?

Answer 27

A: It indicates the worst prognosis.

Question 28

Q: What is accessory breast tissue?

Answer 28

A: It occurs along the milk line when normal regression fails.

Question 29

Q: What does athelia refer to?

Answer 29

A: The absence of a nipple.

Question 30

Q: What is amastia?

Answer 30

A: The absence of breast tissue.

Question 31

Q: What does amazia mean?

Answer 31

A: Breast tissue is lacking, but a nipple is present.

Question 32

Q: What is polymastia?

Answer 32

A: The presence of accessory breast tissue, most commonly found in the lower axilla.

Question 33

Q: What does polythelia refer to?

Answer 33

A: The presence of supernumerary (or accessory) nipples.

Question 34

Q: What is Poland sequence?

Answer 34

A: It involves unilateral hypoplasia or absence of the breast and pectoral muscle, often with upper limb anomalies like syndactyly, brachydactyly, or oligodactyly, possibly due to diminished blood flow in the subclavian artery during early fetal development.

Question 35

Q: What is a common presentation of breast disease?

Answer 35

A: A palpable breast mass or thickening.

Question 36

Q: What changes in the breast may indicate disease?

Answer 36

A: Change in the size or appearance of the breast.

Question 37

Q: What symptom might a person experience with breast disease?

Answer 37

A: Breast pain.

Question 38

Q: What kind of skin changes can occur in breast disease?

Answer 38

A: Various skin changes, including redness or dimpling.

Question 39

Q: What nipple issues may indicate breast disease?

Answer 39

A: Nipple discharge or inversion.

Question 40

Q: How can breast disease be detected in asymptomatic individuals?

Answer 40

A: As an abnormal finding on a screening mammogram.

Question 41

Q: What percentage of women experience nipple discharge?

Answer 41

A: Approximately 20% to 25%.

Question 42

Q: How can nipple discharge be classified?

Answer 42

A: As physiologic discharge, pathologic discharge, or galactorrhea.

Question 43

Q: What percentage of pathologic nipple discharge cases may indicate malignancy?

Answer 43

A: Malignancy is found in 5% to 15% of cases.

Question 44

Q: What is the most common malignancy associated with nipple discharge in the absence of other findings?

Answer 44

A: Ductal Carcinoma In Situ (DCIS).

Question 45

Q: Is nipple discharge common in children and adolescents?

Answer 45

A: No, it is uncommon.

Question 46

Q: What should be evaluated regarding nipple discharge?

Answer 46

A: Whether it is spontaneous or provoked, unilateral or bilateral, and the appearance of the fluid (milky, purulent, serous, etc.) to help determine the cause.

Question 47

ddx for galactorrhea 6 drug endocrine normal neoplasm

Answer 47

Milky discharge (galactorrhea): caused by * Pregnancy, postpartum or postabortion states, * Hypothyroidism, * Hypogonadism, * Overstimulation from manual manipulation, * Prolactin secreting tumors and * Certain drugs like antipsychotics eg.Phenothiazine, Cimetidine (Tagamet),Metoclopramide, Methyldopa, morphine, codien

Question 48

Q: What is multicolored/sticky discharge often associated with?

Answer 48

A: A cystic lesion.

Question 49

Q: What condition is characterized by distension of subareolar ducts with fibrosis and inflammation?

Answer 49

A: Mammary duct ectasia.

Question 50

Q: What does purulent discharge suggest?

Answer 50

A: An infection of the breast, such as cellulitis or abscess.

Question 51

Q: What should be done with purulent discharge?

Answer 51

A: It should be sent for culture with susceptibility testing.

Question 52

Q: What is serous discharge from the nipple or areola associated with?

Answer 52

A: Excretion from Montgomery tubercles.

Question 53

Q: What are Montgomery tubercles?

Answer 53

A: Small soft papules located around the areola, also called Morgagni tubercles.

Question 54

Q: What do Montgomery tubercles look like?

Answer 54

A: They are small elevations on the surface of the areola.

Question 55

Q: What can cause serosanguineous nipple discharge?

Answer 55

A: Intraductal papilloma, fibrocystic changes, or rarely, cancer.

Question 56

Q: What are other causes of serosanguineous drainage?

Answer 56

A: Traumatic nipple erosions (jogger's nipple) and eczema.

Question 57

Q: How can traumatic nipple erosions and eczema be treated?

Answer 57

A: With nipple hygiene and warm compresses.

Question 58

Q: What is the most common cause of bloody nipple discharge in infants and young children?

Answer 58

A: Mammary duct ectasia.

Question 59

Q: What can cause grossly bloody nipple discharge?

Answer 59

A: Intraductal papilloma, chronic nipple irritation, cold trauma, mammary duct ectasia, chronic cystic mastitis, and breast cancer.

Question 60

Q: What is apocrine chromhidrosis?

Answer 60

A: The secretion of colored sweat by the apocrine glands of the areola, which may be confused with bloody nipple discharge.

Question 61

Q: When does apocrine chromhidrosis typically occur?

Answer 61

A: During exercise or manual pressure around the areola.

Question 62

Q: What are the cytologic examination and cultures results for apocrine chromhidrosis?

Answer 62

A: Both are negative.

Question 63

Q: Is treatment indicated for apocrine chromhidrosis?

Answer 63

A: No treatment is indicated for this condition.

Question 64

Q: What does mastitis refer to?

Answer 64

A: Inflammation of the breast tissue that may or may not be accompanied by infection.

Question 65

Q: What are the three types of mastitis based on location?

Answer 65

A: 1. Subareolar, 2. Intramammary (breast abscess), 3. Retromammary (submammary).

Question 66

Q: How is mastitis classified?

Answer 66

A: Into three major categories: 1. Infectious, 2. Noninfectious, 3. Mastitis associated with malignancy.