Flashcards in Breast Surgery Deck (14):
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
What are the most common breast masses?
50 infiltrating ductal carcinoma
What is a fibroadenoma?
Firm, mobile,rubbery mass in young women
dx FNA and U/S
tx is elective removal
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
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
How do you treat sclerosing adenosis?
Tx careful observation or prophylactic bilateral simple mastectomy; not precancerous, but is a risk factor for cancer
How do you treat atypical ductal hyperplasia?
Tx is excision, not precancerous, but high risk of becoming cancer
What is an intraductal papilloma?
Presents as bloody nipple discharge; tx galactogram/ductogram-guided excision
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
What is dystrophic calcification?
Presents as breast lump following trauma, but work up as a cancer until proven otherwise
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
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
What is Paget's disease?
presents as "crusty" nipple eczema, indicates underlying infiltrating ductal carcinoma