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Jason's MD2 ED/Amb Rotation > Breast Disease > Flashcards

Flashcards in Breast Disease Deck (18):
1

minor factors on history for someone with breast changes?

any children before?
breastfeed
menarche
menopause (natural/artificial)
HRT
past medical of breast disease
radiation therapy (hodkin's lymphoma)
smoking, ETOH
allergies

2

breast lump history type that are worrying?

atypical ductal hyperplasia

3

if mastalgia and varies with menstrual cycle, should we be worried?

less so

4

differential for young woman with breast lump that doesn't vary with menstrual cycle?

fibroadenoma (usu younger age group)
cyst

5

redness and tenderness/pain around a lump in breast ddx??

inflammatory breast cancer
abcess

6

fibroadenomas and cysts painful?

just on palpation, mild tenderness

7

which nodes to examine in breast exam?

axilla
supraclav

8

quick breast cancer screen to rule out metastatic disease

hepatomegaly
lung
spine punch

9

how to investigate new breast lump in young woman?

U/S both breasts

10

38 year old 3/12 hx, breast tenderness that varies with menstrual cycle ddx? inv?

fibrocystic change (30s-40s pre-menopausal)

mammogram
U/S

11

breast pain rx?

not caffeine
vitamin B6
can try evening primrose oil

tamoxifen/androgens but has side effects

12

U/S for breast screening?

Nope, better for lumps

screen with mammogram

13

send off the breast cystic fluid?

yes if there's blood
otherwise discard
could have any colour

14

nipple discharge questions?

blood?
pus?
milk?
clear/yellow
any masses?

spontaneous or express-able (which duct)

15

investigations for nipple discharge

mammogram
U/S focused retro-areola

16

if bloody discharge from nipple, why investigate so fiercely?

1. papilloma (growth inside duct)

2.cancer
3. duct ectasia (dilation of ducts)
-green,

17

what to ask someone who presents with breast lump?

nipple changes
growing?
family history: 1st and secondary degree
lymph node tenderness
ovarian cancers
BRCA1 BRC2

18

when you want to use adjuvant therapies?

high grade
lymph involvement
or HER2