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Flashcards in Breast Surgery Deck (14):
0

How do you manage a breast mass on exam?

First, get mammogram to characterize mass and rule out other masses--> get core needle biopsy --> excisional biopsy if needle inadequate

1

What are the most common breast masses?

50 infiltrating ductal carcinoma

2

What is a fibroadenoma?

Firm, mobile,rubbery mass in young women
dx FNA and U/S
tx is elective removal

3

What is a phyllodes tumor?

Huge, benign tumors that distort the breast
dx core or incisional biopsy since FNA is insufficient
tx excision with negative margins

4

What is a fibrocystic change?

Multiple, bilateral lumps that vary with the menstrual cycle; if dominant or persistent lump --> aspiration --> excisional biopsy if mass recurs or persists

5

How do you treat sclerosing adenosis?

Tx careful observation or prophylactic bilateral simple mastectomy; not precancerous, but is a risk factor for cancer

6

How do you treat atypical ductal hyperplasia?

Tx is excision, not precancerous, but high risk of becoming cancer

7

What is an intraductal papilloma?

Presents as bloody nipple discharge; tx galactogram/ductogram-guided excision

8

What is acute mastitis?

breastfeeding women get staph/strep infection through cracks in nipple with yellowish discharge, tx antibiotics and warm compresses, may develop into breast abscess

9

What is dystrophic calcification?

Presents as breast lump following trauma, but work up as a cancer until proven otherwise

10

What are some of the breast cancer buzzwords?

family history, ill-defined or fixed mass, skin or nipple retraction, peau d'orange, nipple eczema, and palpable axillary node

11

How do you treat breast cancer? What about DCIS and LCIS?

Depends on stage
if axillary LN involvement, tx chemo if pre-menopausal, tamoxifen if post-menopausal
chemo in pregnancy if stage III or IV
DCIS: simple mastectomy
LCIS: careful observation or prophylactic bilateral simple mastectomy; not precancerous, but is a risk factor of breast cancers

12

What is Paget's disease?

presents as "crusty" nipple eczema, indicates underlying infiltrating ductal carcinoma

13

Where are the common metastasis sites for breast cancer?

Bone, liver, brain