Breast Health

Question 1

What days of the menstrual cycle are ideal for self breast examination

Answer 1

Days 3-10

Question 2

what are the breast screening recommendations for women ages 20-39

Answer 2

Clinical Breast Exam

Question 3

what are the breast screening recommendations for women ages >40 (2)

Answer 3

1- Clinical Breast Exam

2- Mammogram

Question 4

Why is ultrasound used in addition to Mammogram with breast imagery?

Answer 4

Because it allows for assessment of a targeted area

Question 5

What is the primary diagnostic tool for breast cancer for women greater than 30

Answer 5

Ultrasound

Question 6

How is MRI utilized in diagnosing breast cancer?

Answer 6

Adjunct to mammo in high risk women

Question 7

What age is fibroadenoma most common in?

Answer 7

Under age 30

Question 8

When can a fibroadenoma grow rapidly?

Answer 8

1- during adolescence
2 Pregnancy
3- lactation

Question 9

How does a fibroadenoma present

Answer 9

Small pea or marble like, painless lump in once breast

Question 10

Fluid filled lesions in the terminal ducts or lobule

Answer 10

Breast Cyst

Question 11

What phase are breast cyst most common?

Answer 11

Luteal phase

Question 12

When do breast cyst typically disappear?

Answer 12

During menopause

Question 13

What will the patient complain of when they have a breast cyst?

Answer 13

bilateral, full, heavy or aching breast with pain radiating to axilla or arm

Question 14

What are some medication treatments for Breast cyst (3)

Answer 14

1- Danazol
2- Tamoxifen
3- Bromocriptine

Question 15

What are some practical treatments for breast cyst?

Answer 15

1- supportive bra
2- heat
3- cold or gentle massage
4- NSAIDs

Question 16

What are some dietary guidelines when a patient has breast cyst (2)

Answer 16

1- decrease caffeine

2- Take Vit E or evening Primrose oil

Question 17

What is Galactorrhea?

Answer 17

Milky nipple discharge unrelated to normal milk production in breast

Question 18

What medications can cause Galactorrhea (3)

Answer 18

1- Antihypertensive
2- antidepressants
3- antipsychotics

Question 19

What are some diagnostic test used in working up nipple discharge (3)

Answer 19

1- r/o pregnancy
2- Serum Prolactin
3- TFT

Question 20

Benign inflammatory condition of increased glandular secretion and dilation of the lactiferous ducts and can be present perimenopausal or post menopausal

Answer 20

Duct Ectasia

Question 21

How does Duct Ectasia present (2)

Answer 21

1- Unilateral or occasional bilateral, cheesy, viscous nipple discharge
2- Nipple retraction or lump behind nipple

Question 22

What are some differentials for ductal ectasia?

Answer 22

1- intraductal carcinoma
2- periductal mastitis
3- Pagels disease

Question 23

This breast abnormality is caused by proliferation and overgrowth of ductal epithelial tissue

Answer 23

Intraductal Papilloma

Question 24

What age group is intraductal papilloma most common in?

Answer 24

45-50

Question 25

What type of discharge can be noted in intraductal papilloma?

Answer 25

Bloody, serosanguineous

Question 26

How does the mass present with intraductal papilloma? (2)

Answer 26

1- Soft, poorly delineated | 2- or small, wart-like growth near nipple

Question 27

Nonpuerperal mastitis characterized by periareolar inflammation with a mass or abscess or a mammary duct fistula

Answer 27

Periductal mastitis

Question 28

What age group is periductal mastitis often seen in?

Answer 28

reproductive age

Question 29

How does the breast present in periductal mastitis

Answer 29

1- Reddened, painful nipple or breast with or without mass | 2- Nipple retraction or a spontaneous creamy discharge

Question 30

What is a risk factor for Periductal Mastitis

Answer 30

Smoking

Question 31

What is the most common female malignancy

Answer 31

Breast Cancer

Question 32

One in ____ women will develop breast cancer in their lifetime and risk increase with aging

Answer 32

8

Question 33

What are the risk factors for breast cancer?

Answer 33

``` 1- Female 2- Age 3- Family h/o BRCA 1 & 2 4- early menarche 5- late menopause 6- late or no children 7- ethnicity: white ```

Question 34

How is Ductal cancer in-situ

Answer 34

1- Wide surgical excision or mastectomy if extensive | 2- radiation to the breast following excision

Question 35

What is the most common for of breast cancer (70%)

Answer 35

Invasive ductal carcinoma

Question 36

This type of breast cancer begins in the duct, grows into the surrounding tissue, and has the ability to spread outside of the breast by lymphatics or blood vessels

Answer 36

Invasive ductal carcinoma

Question 37

How does invasive ductal carcinoma usually present?

Answer 37

as a palpable mass or as an abnormal nodule on a mammogram and/or ultrasound

Question 38

What is the treatment for Invasive ductal carcinoma? (3)

Answer 38

1- Intitally surgically with wide excision or with mastectomy with surgical evaluation of the lymph nodes 2- Radiation of the remaining breast tissue 3- additional antihormonal or chemo therapy

Question 39

What is the second most common form of breast cancer? (5-10%) This type of breast cancer is more likely to present with two or more separate tumors and is more likely to be bilateral than other breast cancers

Answer 39

Invasive lobular carcinoma

Question 40

This type of breast cancer originates in the lobules, and then invades the surrounding tissue and can spread via the lymph channels or blood stream

Answer 40

Invasive lobular carcinoma

Question 41

Why is Invasive lobular carcinoma difficult to identify on mammogram therefore making it more advanced when it is diagnosed?

Answer 41

because it resembles the texture and appearance of normal breast tissue

Question 42

An aggresive form of breast cancer that presents as swelling, redness, warmth, and possible peau d'orange of the breast skin due to blocked lymph drainage from cancer within the del-mar lymphatic system.

Answer 42

Inflammatory breast cancer

Question 43

What can Inflammatory breast cancer mimic?

Answer 43

Mastitis

Question 44

What is the treatment of inflammatory breast cancer? (3)

Answer 44

1-Chemo 2-and/or radiation 3- surgery

Question 45

This type of breast cancer is an uncommon presentation of ductal carcinoma that infiltrate's the nipple causing changes that range from a rash, itching, redness, flaking, bleeding, or a recurrent scab or nonhealing sore.

Answer 45

Pagets Disease

Question 46

How is Paget's Disease diagnosed (3)

Answer 46

1- Breast examination 2- mammogram 3- nipple biopsy

Question 47

What is the recommended treatment for Paget's Disease

Answer 47

Mastectomy

Question 48

What is staging of breast cancer based on (3)

Answer 48

1- tumor size and extension (stage I) 2- Node number and extent (II-III) 3- Distant metastasis (IV)

Question 49

What is the 5 year survival for stage I

Answer 49

95-100%

Question 50

What is the 5 year survival for stage II

Answer 50

86%

Question 51

What is the 5 year survival for stage III

Answer 51

57%

Question 52

What is the 5 year survival for stage IV

Answer 52

20%

Question 53

How does Acupuncture help as a complementary therapy in breast cancer treatment?

Answer 53

Gives relief of hot flashes, fatigue and arthralgias

Question 54

How does physical exercise help as a complementary therapy in breast cancer

Answer 54

effective in relieving fatigue

Question 55

How does cognitive behavioral therapy help as a complementary therapy in breast cancer treatment?

Answer 55

Effective in the relief of insomnia