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Clin med sem 2 > Breasts > Flashcards

Breasts Flashcards

(58 cards)

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1
Q

Supernumerary Nipple- pathophysiology

A

An extra nipple

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2
Q

Supernumerary Nipple- S/S & PE

A

Found along milk line
Not dangerous
Darken w/ pregnancy
Inc in size/location - hormones during pregnancy

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3
Q

Gynecomastia- pathophysiology

A

Enlargement/swelling of breast

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4
Q

Gynecomastia- epidemiology

A

Meds - resparadone, spiralactone

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5
Q

Gynecomastia- S/S & PE

A

Unilateral or bilateral
Indicator of hormone imbalance - inc estrogen
Males - during puberty or in elderly - dec testosterone

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6
Q

Mastodynia (Mastalgia)- pathophysiology

A

Common

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7
Q

Mastodynia (Mastalgia)- S/S & PE

A

Cyclical - hormonal changes
Inc w/ OCPs or HRT
During luteal phase

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8
Q

Mastodynia (Mastalgia)- treatment

A

Reassurance

Vit B6

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9
Q

Mastitis- pathophysiology

A

Breast infection

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10
Q

Mastitis- cause

A

Staph aureus

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11
Q

Mastitis- epidemiology

A

Lactating women

  • poor latch
  • incomplete emptying of breast
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12
Q

Mastitis- S/S & PE

A 
Abscess
Unilateral tenderness, heat
Fever/chills
Body aches 
Classic - one quadrant breast/lobule affected
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13
Q

Mastitis- labs & imaging

A

Culture - milk

- not usually done

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14
Q

Mastitis- treatment

A

Abx

  • Dicloxacillin - 500mg PO Q6hr x 10 days
  • Cephalosporin 10-14 days

Continue breastfeeding

Surgery - abscess

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15
Q

Breast Abscess- epidemiology

A

Lactation

Subareolar abscess in nonlactating - nipple piercing

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16
Q

Breast Abscess- S/S & PE

A

Painful
Swollen
Red, tender
Induration - filled w/ pus

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17
Q

Breast Abscess- treatment

A

I&D
Abx

Don’t respond to treatment - suspect inflammatory breast cancer
- esp if axillary lymphadenopathy

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18
Q

Fat Necrosis of Breast- pathophysiology

A

Benign

Damaged/dead breast tissue

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19
Q

Fat Necrosis of Breast- cause

A

Hx - trauma or surgery

Post - breast biopsy, surgery, radiation

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20
Q

Fat Necrosis of Breast- S/S & PE

A

Firm nodule

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21
Q

Fat Necrosis of Breast- diagnosis

A

Biopsy - to confirm

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22
Q

Fat Necrosis of Breast- labs & imaging

A

Imaging - can look like carcinoma

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23
Q

Fat Necrosis of Breast- treatment

A

Excision not needed

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24
Q

Fat Necrosis of Breast- prognosis

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A

No inc risk of breast cancer

25
Fibrocystic- pathophysiology
Benign - most common
26
Fibrocystic- cause
Hormonal changes – inc in size w/ estrogen or progesterone
27
Fibrocystic- epidemiology
30-50
28
Fibrocystic- S/S & PE
Bilateral - multiple Mobile Cyclic pain Breast tenderness Multiple lesions - not carcinoma - get biopsy w/ any concern
29
Fibrocystic- treatment
``` Supportive Bra Avoid caffeine Low salt diet Vt E Evening primrose oil ```
30
Fibrocystic- prognosis
Will stop w/ menopause
31
Fibroadenma- pathophysiology
Benign - glandular breast tissue
32
Fibroadenma- epidemiology
Young W | AA
33
Fibroadenma- S/S & PE
``` Round or ovoid Firm, smooth, rubbery Discrete Mobile Non tender ```
34
Fibroadenma- diagnosis
Core needle biopsy OR | 3-6m f/u - w/ repeat U/S and breast exam
35
Fibroadenma
None if diagnosis by biopsy Surgery - if pt wants Cryoablation
36
Nipple Discharge- S/S & PE
Nl Lactation Galactorrhea - Milky white discharge - bilateral - frequent result of hyperprolactinemia - meds or tumor Pathologic Nipple Discharge - Causes - duct ectasia, intraductal papilloma, carcinoma - unilateral - single duct - Serous, bloody, serosanguineous - Purulent w/ breast abscess
37
Nipple Discharge- diagnosis
Pathologic - U/S or Mammogram - cytogological of discharge - not helpful -> neg doesn’t rule out cancer
38
Nipple Discharge- treatment
Pathologic: Refer Surgery - involved duct - tx and diagnosis
39
Breast Cancer- pathophysiology
Estrogen excess - length of reproductive life - Parity - age at first birth
40
Breast Cancer- cause
BRCA1 and BRCA2
41
Breast Cancer- epidemiology
``` inc w/ age 61 Risk: - Nullparity - Early menarche - Late menopause - long term estrogen or radiation exposure - Delayed childbearing >30 - 1st deg relatives - hx of endometrial ```
42
Breast Cancer- S/S & PE
Non-invasive Ductal carcinoma in-situ - no palpable mass Lobular carcinoma in-situ ``` Invasive Invasive ductal carcinoma - 80-85% - underlying palpable mass Invasive lobular carcinoma Special types ```
43
Breast Cancer- diagnosis
Early - mammographic changes and no mass PE, mammography, US, fine need biop, core biopsy, excisional biopsy Tumor marking - estrogen and progesterone receptor - HER2/NEU - histologic Additional testing - MRI, CT, chest xray, bone scan, PET scan
44
Breast Cancer- labs & imaging
Breast Self-Awareness - be familiar w/ breasts - report any changes to PCP Clinical Breast Exam - No real benefit if getting mammograms Mammography - best screening - ACS - yearly at 40, every 2 yr at 55yo - USPSTF - yearly at 50-75 - start before 50 is pt decision - higher rates of false pos and unneeded biopsies -> more estrogen MRI - high risk - MRI + mammogram yearly at 30yo - BRCA, 1st deg relat w/ BRCA, prior radiation to chest
45
Breast Cancer- treatment
``` Stage Early - lumpectomy w/ sentinel node biopsy Mastectomy Radiation Chemo or hormonal therapy Tamoxifen - estrogen + receptor Palliative ```
46
Breast Cancer- prognosis
Factors - Tumor size, grade - Lymph node involvement - age F/U Care - long term f/u - most will recure w/in 2-5 yr - first 2yr - examine every 6m w/ mammogram -> then annually
47
Pagaet Disease of Breast- pathophysiology
Rare - 1% of BC
48
Pagaet Disease of Breast- S/S & PE
Eczematous/ulcerated lesion on nipple Pruritic Burning Painful
49
Pagaet Disease of Breast- diagnosis
Full thickness biopsy
50
Pagaet Disease of Breast- treatment
Refer | mastectomy
51
Lobular Carcinoma- pathophysiology
Incidental finding Inc risk of developing into breast Cancer
52
Lobular Carcinoma- treatment
Refer Excise lesion Chemo
53
Invasive Carcinoma- S/S & PE
``` Fixed firm nodule non tender - but can have pin Dimping Nipple discharge Breast size change Skin thinkening - peau d'orange Eczematous chnge Axillary node enlargemtn Palpable supraclavicular/infraclvicular nodes Arm edema ``` Upper, outer quadrant - most common area
54
Breast Cancer in Men- pathophysiology
Rare
55
Breast Cancer in Men- cause
BRCA2
56
Breast Cancer in Men- epidemiology
>50yo | Inc w/ prostate ca
57
Breast Cancer in Men- S/S & PE
Painless lump beneath areola Nipple discharge retraction ulceration
58
Breast Cancer in Men- prognosis
Poor - worse than women

Clin med sem 2 (30 decks)

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