Eval of Common Breast Problems Flashcards
What skin findings are significant in a breast exam?
What imaging is the best in evaluating a breast mass?
What are the most common causes of breast masses?
- Fibrocystic changes
What group of women should always have biopsies of breast masses?
Postmenopausal women because their breasts are not changing as much (e.g. with the menstrual cycle) and they have an increased risk for breast CA.
What are the physical exam findings for fibrocystic change of the breast?
Vague thickening or rubbery, ill-defined mass or density
What are the physical exam findings for a breast cyst?
Discrete fluid-filled mass
What are the physical exam findings for a fibroadenoma?
Smooth-margined solid mass in a premenopausal woman
What are the physical exam findings of a breast lipoma?
Smooth, soft, mobile mass
What are the physical exam findings of breast cancer?
Discrete solid mass with irregular edges
What size mass can be evaluated by FNA?
At least 7 mm
What kind of biopsy can be done for masses not visualized by US, but seen on mammography?
Stereotactically guided core needle bx
Mastalgia is usually related to
Hormonal and fibrocystic changes of the breast
What are common benign causes of focal persistent breast pain?
Cysts, fibroadenomas, mastitis, and abscess
What classes of medications are associated with noncyclical mastalgia?
Antidepressants and antihypertensives
What are two chest wall syndromes that may manifest as breast pain?
Costochondritis and Tietze syndrome
What is Tietze syndrome?
SWELLING and inflammation of the costal cartilages
What is costochondritis?
Temporary inflammation (not swelling) of the costal cartilage - the cartilage that connects each rib to the sternum at the costosternal joint
How does one differentiate between costochondritis and Tietze syndrome
There is inflammation of the costal cartilage in both diseases, but Tietze syndrome has swelling as well
What is the treatment of Tietze syndrome and costochondritis?
NSAIDs and rest
What is the treatment for cyclical mastalgia?
Evening primrose oil, NSAIDs, caffeine/chocolate abstinence, low-fat diet or 3-to-6 month trial of tamoxifen.
What kind of nipple discharge warrents surgical evaluation?
Spontaneous, recurrent, unilateral and from a single duct