Chapter 18 - The Breast

Question 1

what is the main function of the breasts?

Answer 1

produce milk

Question 2

what are the two main types of tissues in the breast

Answer 2

glandular (lobules and ducts) and stromal (fat and CT)

Question 3

during puberty, what type of cell changes occur in the breast?

Answer 3

hyperplasia – increase in cell number so size of breast increases

Question 4

what type of cell change occurs in the breast during menstruation?

Answer 4

cyclic hyperplasia then involuation- increase in size during menstruation, then decrease

Question 5

what type of change occurs in the breast during pregnancy and lactation?

Answer 5

hypertrophy of the gland and duct tissues which increase the size of the breast

Question 6

what type of change occurs in the breast after menopause?

Answer 6

breasts decrease in size from lowering hormone levels

Question 7

what are the two main types of breast changes? and what types of diseases occur with them?

Answer 7

benign – fibrocystic breast disease and fibroadenomas
malignant – breast carcinoma

Question 8

what is galactorrhea

Answer 8

milk production when a woman isn’t pregnant

Question 9

what is gynecomastia

Answer 9

breast development in males from hormone imbalances

Question 10

what screening test is most useful for postmenopausal women whose breasts have more fat?

Answer 10

mammogram

Question 11

when should you get your first mammogram?

Answer 11

age 35-40 (based on family history)

Question 12

what screening test is most sensitive and may be better at detecting a small carcinoma?

Answer 12

MRI

Question 13

what screening test is usually the first choice for young women?

Answer 13

ultrasound

Question 14

how are breasts developed? and what is left over after these disappear?

Answer 14

mammary ridges; nipples left over (occasional extra nip)

Question 15

acute mastitis

Answer 15

inflammation of the breast

Question 16

main cause of acute mastitis

Answer 16

staph infection

Question 17

what are symptoms of mastitis?

Answer 17

swelling, pain, redness, lumps

Question 18

what is the most common benign change in women?

Answer 18

fibrocystic breast disease

Question 19

What is the main cause of fibrocystic breast disease?

Answer 19

unknown; idiopathic

Question 20

is fibrocystic breast disease benign or metastatic?

Answer 20

benign

Question 21

what age range is fibrocystic breast disease most common in?

Answer 21

20-40

Question 22

most common signs and symptoms of fibrocystic breast disease

Answer 22

painful lumps in breast, size of lump changes with period, nipple discharge, inflammation

Question 23

Treatment for fibrocystic breast disease

Answer 23

Small - nothing
Aspiration of cyst
Cut it out with surgery

Question 24

what is a fibroadenoma

Answer 24

benign, well-circumscribed tumor in the breast

Question 25

signs/symptoms of fibroadenomas

Answer 25

painless, size doesn't fluctuate (common in young women)

Question 26

treatment for fibroadenomas

Answer 26

remove with surgery

Question 27

what is the most frequently diagnosed cancer in American women?

Answer 27

breast cancer

Question 28

what is the leading cause of death in women ages 40-44

Answer 28

breast cancer

Question 29

what is the most common type of breast carcinoma (sporadic vs familial)

Answer 29

sporadic - 95%

Question 30

risk factors for breast cancer (6)

Answer 30

-prolonged estrogen exposure (no children, not breastfeeding, etc.) -obesity -alcohol -sedentary -caucasian -hormone replacement therapy

Question 31

mutations in which genes increase the risk of breast or ovarian cancer?

Answer 31

BRCA 1 and BRCA2

Question 32

can you inherit breast cancer from both parents?

Answer 32

yes

Question 33

what do BRCA1 and BRCA2 do?

Answer 33

encode proteins for DNA repair (common cause of cancer)

Question 34

what classification of breast cancer is most common at diagnosis?

Answer 34

invasive (has already metastasized)

Question 35

well-differentiated cells in breast cancer

Answer 35

good prognosis; less aggressive; usually resemble normal breast tissue

Question 36

poorly-differentiated cells in breast cancer

Answer 36

poor prognosis; more aggressive

Question 37

how do you officially diagnose breast carcinoma?

Answer 37

biopsy of the sentinel lymph node

Question 38

Modalities of treatment for breast cancer

Answer 38

lumpectomy and rim of benign tissue, then radiation/chemotherapy if needed

Question 39

After a biopsy, what would ER or PR indicate?

Answer 39

more favorable prognosis; less aggressive; give Tamoxifen to block the receptors and slow growth

Question 40

What would HER2 indicate?

Answer 40

more aggressive; less responsive to treatment, but can use HER2 blockers to slow growth

Question 41

what does it mean if a woman is triple negative

Answer 41

no ER no PR no HER2

Question 42

what is the treatment for recurrent metastatic carcinoma of the breast?

Answer 42

control the growth relieve symptoms improve QOL

Question 43

what does hormone replacement therapy increase the risk for?

Answer 43

breast cancer and ovarian cancer