Breast Disease Flashcards
RFs for breast cancer
Prior breast bx showing atypical ductal hyperplasia or lobular CIS
Prolonged estrogen exposure from early menarche, late menopause
Combination HRT
Not breast-feeding
High BMI
Alcohol
Smoking
History of chest radiation from age to 10 to 30
Nonproliferative breast lesion
Benign
Mild hyperplasia
Papillary apocrine change
No increase risk of future development of breast cancer
Lobular carcinoma in situ
Not a precursor lesion for breast cancer but a risk marker for future breast cancer
10 to 20% risk of developing invasive cancer in 15 years
Surgical excision
Annual MRI
Consider TAMOXIFEN, raloxifene, AI
?ppx mastectomy
Pharmacologic therapy for mastalgia, second line
Danazol 100 mg bid
Tamoxifen 10 mg/day
Management of atypical hyperplasia
Surgical excision as invasive cancer is detected 10-20% of cases
Annual MRI
tamoxifen
Raloxifene or aromatase inhibitorS (postmenopausal only)
Which imaging modality is recommended for women and younger than 30?
Older than 30?
US
Diagnostic mammo + US
How do aromatase inhibitors work?
Anastrozole
Letrozole
Block conversion of androstenedione and testosterone to estrogen
What is the most common cause of bloody nipple discharge
Intraductal papilloma
What is the most common cause for a solid breast math
Fibroadenoma
20% of Padgett disease of the breast is associated with
Underlying intraductal carcinoma
What is the false positive rate for mammography
10%
