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Breast Disorders Flashcards

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1
Q

Diagnostic or screening mammography?

  • two craniocaudal views
  • two mediolateral oblique views
A

screening

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2
Q

what differentiates screening mammography from diagnostic mammography?

A

additional views

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3
Q

implants are radiolucent or radiopaque?

A

radiopaque

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4
Q

2 reasons for timely evaluation with mammography

A

r/o CA

relieve anxiety

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5
Q

which imaging modality?


inconclusive MMG results

breasts of young women

dense breast tissue
A

US

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6
Q

what imaging modality can differentiate between a solid and cystic mass?

A

US

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7
Q

what type of contrast is used for breast MRI? What labs should be checked?

A

gladolinium, BUN/Cr

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8
Q

What type of bx?

determine if lump is simple cyst or not

A

FNA

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9
Q

what type of bx?

used to obtain samples from larger, solid breast mass

A

core needle bx

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10
Q

Which mastalgia type?

pain fluctuates w. menstrual cycle

Fibrocystic changes

A

cyclical

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11
Q

Which mastalgia type?

pain felt in breast, but originates elsewhere

A

extra-mammary

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12
Q

Mastalgia tx in addition to reassurance…

A

physical support

acetaminophen/NSAIDs

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13
Q

Mastitis is MC in what population?

A

lactating women

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14
Q

Patient presents with:

hard, red, tender swollen area of one breast

Fever

A

mastitis

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15
Q

Mastitis is MC caused by what pathogen…

A

staph aureus

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16
Q

Mastitis is dx via…

A

clinical presentation

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17
Q

2 drugs to tx mastitis

A

dicloxicillin

cephalexin

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18
Q

Can patients continue breast feeding with mastitis?

A

yes

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19
Q

an area of fluctuance on the breast with erythema and tenderness is suggestive of…

A

breast abscess

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20
Q

breast abscess is treated via…

A

I&D

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21
Q

Patient presents with:

-smooth, mobile mass
+/- tenderness
well defined on palation

A

breast cyst

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22
Q

breast cyst is common between what ages?

A

35 and 50

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23
Q

simple breast cysts often need no intervention. But, if sxs present, what should be done?

A

FNA

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24
Q

Complex cysts render increasted risk of malignancy. What should be done?

A

Bx +/- excision

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25
Patient presents with... - well-defined, mobile mass - firm, nontender - increased size w. estrogen and pregnancy
fibroadenoma
26
this is a benign, solid tumor that contains glandular and fibrous tissue. common in ages 15-35
fibroadenoma
27
what is first line mgmt for fibroadenoma?
core needle bx
28
if fibroadenoma increases in size, what is indicated?
excision to r/o malignant change
29
this is a fibroepithelial tumor that can be classified as benign, borderline, or malignant
phyllodes tumor
30
spontaneous, unilateral single duct nipple d/c is considered _____ discharge
pathologic
31
What is a common cause of pathologic nipple d/c?
intraductal papilloma
32
bilateral, multiple duct d/c associated with stimulation...
physiologic d/c
33
what is a common cause of physiologic d/c?
galactorrhea (via prolactinoma)
34
Psychotropic agents can cause...
nipple d/c
35
2nd leading cause of CA death among women...
breast CA
36
2 biggest RFs for breast CA
gender, advancing age
37
women with _______ can have up to a 72% risk of developing breast CA in their lifetime...
BRCA 1 or BRCA 2
38
men with _____ mutation have higher risk of breast Ca
BRCA 2
39
Best time to perform breast exam is during the ____ phase of the menstrual cycle
follicular
40
which organization recommends against CBE?
ACS
41
which organization recommends CBE every 1-3 years, or annually if ? 40?
national comprehensive cancer network
42
which organization suggests clinicians offer CBE with informed, shared decisionmaking?
ACOG
43
screening for average risk women should occur via ______ if between ages...
mammogram 40-49
44
All women should receive mammogram screening at what age?
50+
45
mammogram screening can stop at what age?
75
46
frequency of mammography?
1-2 years
47
Breast cancer classifications by anatomical origin?
lobular/ductal
48
breast cancer classification by hormone receptivity
estrogen/progesterone receptor expression
49
what growth factor receptor is part of breast cancer classification?
human epidermal growth factor receptor 2 (HER2)
50
MC clinical presentation of breast CA...
palpable mass
51
patient presents with the below, which is concerning for... skin changes (dimplish, nipple retraction, peau d'orange, etc) nipple d/c
breast CA
52
Lobular and ductal lesions that have not yet penetrated the basement membrane...
in situ breast carcinomas
53
does DCIS have potential to invade and progress as cancer?
yes
54
on mammography you see clustered pleomorphic calcifications... this is suggestive of...
DCIS
55
describe physical exam findings for DCIS
WNL
56
can LCIS become invasive cancer if untreated?
no
57
does LCIS have any specific findings on mammogram or US?
no, usually incidental
58
The below describes treatment for... ```  Breast conserving surgery (BCT) with radiation vs. mastectomy  sentinel lymph node biopsy  Adjuvant (hormone) therapy if estrogen (ER) and progesterone (PR) positive  Tamoxifen , Arimidex ```
DCIS
59
does LCIS require treatment?
not in most women
60
does LCIS require treatment?
not in most women
61
What is the MC breast malignancy accounting for 80%?
infiltrating ductal carcinoma (IDC)
62
This type of carcinoma MC presents as palpable mass or mamographic abnormality
IDC
63
Which type of breast cancer? bilateral hormone receptor positive
Infiltrating lobular carcinoma
64
A patient presents with: -Unilateral scaly, raw, vesicular or ulcerated lesion begins on nipple, spread to areola +/- bloody d/c
paget disease of the breast
65
describe the prodrome of paget disease of the breast...
pain, burning, pruritus
66
What type of breast CA? - aggressive - rare
inflammatory breast CA
67
A patient presents with: - pain, tender, firm, enlarged breast - rapid progression - LAD
inflammatory breast CA
68
what are the skin changes commonly found with inflammatory breast CA? (3)
peau d'orange, erythema, warm
69
mets are common with IBC... T or F?
true
70
lymphatic mets spread to...
axillary lymph nodes
71
hematogenous mets commonly spread to...
lung, liver
72
4 tx options for breast CA...
surgery, radiation, chemo, endocrine tx
73
What surgical tx? part of breast containing CA removed.
lumpectomy
74
What surgical tx? entire breast, nipple, areola removed
simple/total mastectomy
75
What surgical tx? entire breast, nipple, areola removed plus axillary lymph nodes
modified radical mastectomy
76
What surgical tx? entire breast, nipple, areola removed plus axillary lymph nodes and pectoralis muscle
radical mastectomy
77
How common is radiation for breast ca?
almost always used
78
External beam radiation occurs for what duration?
4-7 weeks
79
what type of radiation? seeds or wires placed in or near the tumor for shorter time frame (days)
brachytherapy
80
What therapy is indicated for: -primary, metastatic breast CA with lymph node involvement
chemo
81
what is given before surgery to shrink tumor size?
neoadjuvant
82
What is given after surgery to kill remaining CA cells?
adjuvant
83
What two types of breast cancer are responsive to hormone therapy?
ER and PR (+)
84
What two drugs can be given as supplement to chemo and radiation for ER/PR (+) breast cancers?
tamoxifen (premenopausal) Anastrazole (postmenopausal)`
85
how long does HT last for breast cancer tx?
5-10 years
86
What monoclonal Ab can be used for HER2 breast cancers?
herceptin

Women's Health (10 decks)

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