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OBGYN rotation review > breast disorders > Flashcards

breast disorders Flashcards

(55 cards)

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1
Q

where it the primary lymphatic area that breast cancer spreads to

A

axillary lymph nodes

also

internal mammary nodes

supraclavicular nodes (late)

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2
Q

fibrocystic changes cause ___lateral, ____, ____ breast pain

A

fibrocystic changes cause BIlateral, diffuse, cyclic breast pain

(during the luteal phase)

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3
Q

what are some pathologic causes of nipple discharge

A

intraductal papilloma

ductal ectasia (usually has pain)

carcinoma

infection

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4
Q

benign breast masses have ___ margines

whereas

malignant breast masses have ___ margins

A

benign breast masses have well-defined margines

whereas

malignant breast masses have poorly-defined margins

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5
Q

brachytherapy radiation

A

days

(less time than external beam radiation)

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6
Q

which noninvasive breast carcinoma does NOT become invasive if left untreated

A

lobular carcinoma in situ (LCIS)

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7
Q

benign/malignant:

hard, immobile, fixed

A

malignant

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8
Q

what do you need to do before you do an MRI

A

check baseline BUN and creatinine

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9
Q

cluster pleomorphic calcifications on mammogram

A

ductal carcinoma in situ (DCIS)

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10
Q

almost all of PTs w/ this type of breast CA have lymph node involvement

1/3 have distant mets

A

Inflammatory Breast Cancer (IBC)

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11
Q

what dye is used for MRI

A

IV gadolinium

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12
Q

very rare but aggressive breast CA

A

inflammatory breast cancer

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13
Q

what is the treatment for ductal carcinoma in situ (DCIS)

A

Breast Conserving Surgery (BCT) with radatian

or

mastectomy

+/- sentinel lymph node biopsy

+/- tamoxifen/arimidex (if estrogen/progesterone positive)

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14
Q

what are the views for a diagnostic mammogram

A

2 craniocaudal (CC)

+

2 mediolateral oblique (MLO)

+ more views

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15
Q

which diagnostic test is used to obtain samples from a larger, solid breast mass

A

Core-Needle Biopsy

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16
Q

why would you do an MRI

A

detect brast CA in high risk women

to stage breast cancer

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17
Q

benign/ malignant:

smooth, soft to firm, mobile breast masses

A

benign

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18
Q

which noninvasive breast carcinoma is treated as a malignancy b/c of it’s potential to develop into an invasive CA

A

ductal carcinoma in situ (DCIS)

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19
Q

when during the menstrual cycle is the best time to perform a breast exam

A

follicular

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20
Q

what drugs are used for chemoprevention

A

tamoxifen

arimidex

raloxifene

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21
Q

what are the views for a screening mammogram

A

2 craniocaudal (CC)

+

2 mediolateral oblique (MLO)

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22
Q

rapidly progressing pain

tender, firm, enlarged breast

warm, thickened skin

peau d’orange

erythema

A

inflammatory breast CA

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23
Q

why would you do a Fine Needle Aspiration

Study These Flashcards
A

initial method for evaluating a mass with a LOW pretest probability of CA

to determine if a palpable lump is a simple cyst

24
Q

benign/malignant:

skin changes

25
1st: breast pain/ burning/ puritis then scaly/ raw/ vesicular/ ulcerated lesion that begins on the nipple and spreads out to the areola +/- bloody discharge usually unilateral
paget disease of the breast | (PBD)
26
medications can cause \_\_\_lateral, \_\_\_\_, ___ breast pain
medications can cause **UNI**lateral, **focal**, **NON-cyclic** breast pain
27
which diagnostic test is the initial method for evaluating a mass with a low pretest probability of CA
Fine Needle Aspiration
28
chemoprevention (tamoxifen, arimidex, raloxifene) is recommended for which asymptomatic women
over 35 w/out prior hx of breast CA **BUT** are at increased risk
29
with hematogenous spread, where does breast cancer spread to most frequenty
**lungs and liver** also bone, ovaries, brain
30
radical mastectomy
entire breast, lymph nodes, pectoralis muscle (rarely performed)
31
what are GI meds that cause nipple discharge
cimetidine metoclopramide (reglan)
32
what are some physiologic causes of nipple discharge
meds neurogenic stimulation galacotorrhea from prolactinoma
33
what is the most appropriate treatment for stage 1 or 2 breast carcinoma
Breast Conserving Surgery (lumpectomy) with post operative radiation
34
which diagnostic test is NOT recommended for the eval of a breast mass
MRI
35
what treatment is used in primary breast CA metastatic breast CA and **all patient with (+) lymph nodes**
36
what are psych meds that cause nipple discharge
anti-psychotics MAOIs neuroleptics SSRIs TCAs
37
what is herceptin
**drug that targets the HER2/neu protein** (which is a growth promoting protein found in 20% of breast CA) ## Footnote **effective in early stage CA and metastic dz** **used in combo w/ chemo**
38
what areas of the body are radiated when treating breast CA
breast chest wall regional lymph nodes axilla
39
what are opiods that cause nipple discharge
codeine heroin methadone morphine
40
what is treatment for lobular carcinoma in situ (LCIS)
**lifelong surveillance** **+/-** taxmoxifen/arimidex (chemoprevention) **+/-** bilateral **prophylactic** mastectomy
41
neoadjuvant chemo
given before surgery to shrink size of tumor may allow for breast conservation surgery
42
simple mastectomy
entire breast + nipple + areola removed
43
what are anti-HTN meds that cause nipple discharge
methyldopa reserpine verapamil
44
why would you do an US
inconclusive MMG results young women dense breast tissue for better differentation b/w solid and cystic mass to guide tissue core-needle biopsy
45
who should you consider doing genetic screening for BRCA genes?
male breast CA Jewish ancestry + HBOC CA triple negative breast CA diagnosed before 60 patient/ 1st-3rd degree relative CA before 50 patient/ 1st-3rd degree relative w/ invasive ovarian/ fallopian tube/ primary peritoneal CA 2+ 1st-3rd degree relatives w/ breast/prostate/pancreatic CA
46
adjuvant chemo
given after surgery kills the cancer cells left behind
47
external beam radiation takes
5-7 weeks
48
what are hormone meds that cause nipple discharge
estrogen oral contraceptives
49
what is a total mastectomy also called
simple mastectomy
50
modified radical mastectomy
entire breast + nipple + areola removed + **axillary lymph nodes**
51
what is the most common breast malignancy
infiltrating ductal carcinoma
52
the strongest risk factors for breast CA are (2)
female gender age
53
which BRCA gene has a greater risk for breast CA in men
BRCA 2
54
which BRCA gene has a greater risk for breast CA in women
BRCA 1
55
which BRCA gene has a greater risk for ovarian CA
BRCA 1

OBGYN rotation review (14 decks)

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