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OB/GYN > EXAM #1: BENIGN/MALIGNANT BREAST DISEASE > Flashcards

EXAM #1: BENIGN/MALIGNANT BREAST DISEASE Flashcards

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1
Q

What should you do if there is a thickening of breast tissue on breast exam?

A

Re-eval in 2-3 months

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2
Q

What should you do if there is a clinically benign mass on breast exam?

A

Imaging

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3
Q

What should you do if there is a clinically suspicious mass on breast exam?

A

Imaging + biopsy

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4
Q

If a discrete mass is found on breast exam, what should you do?

A
  • Under 40, US

- Over 40, Mammogram

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5
Q

If a discrete mass is found on mammogram and is clinically suspicious, what should you do?

A

Core needle biopsy

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6
Q

What is duct ectasia?

A

Inflammation with dilation of subareolar ducts

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7
Q

How does duct ectasia typically present?

A
  • More common in multiparous postmenopausal women

- Green-brown nipple discharge

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8
Q

If you can’t determine if a breast cyst is cystic or solid, what should you do?

A

FNA

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9
Q

If no fluid can be obtained on FNA of a potential breast cyst, what should you do?

A

Core biopsy

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10
Q

If mastitis is caused by MRSA, what is the proper treatment?

A

1) Aspirate/drain

2) TMP/SMX or Vancomycin

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11
Q

What is a fibroadenoma?

A

Tumor of fibrous tissue and glands

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12
Q

How does fibroadenoma present?

A

Well-circumscribed, mobile, marble-like mass

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13
Q

What is the most common benign neoplasm of the breast?

A

Fibroadenoma (esp. in premenopausal women)

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14
Q

What is a lactating adenoma?

A

Benign stromal tumor seen in 3rd trimester of pregnancy through the time of lactation

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15
Q

What drug can be used to treat lactating adenoma?

A

Bromcriptine

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16
Q

What is the most common cause of bloody nipple discharge in premenopausal women?

A

Itraductal papilloma

*Fibrovascular projections lined by epithelial and myoepithelial cells that bleed

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17
Q

What must intraducal papilloma be distinguished from?

A

Papillary carcinoma

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18
Q

How is intraductal papillloma treated?

A

Excision

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19
Q

What is atypical ductal hyperplasia?

A

Hyperplasia of the cells lining the ducts in the TDLU

*Considered a step toward DCIS, increases risk of breast cancer 5x

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20
Q

What is atypical lobular hyperplasia?

A

Hyperplasia of the cells lining the lobules in the TDLU

*Considered a step toward LCIS, increases risk of breast cancer 5x

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21
Q

What is fibrocystic change in the breast? How does this present?

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A

Development of fibrosis and cysts in the breast that presents as a “lumpy” breast (esp. in the upper outer quadrant)

*Varies with hormonal cycle

22
Q

What are the treatment options for fibrocystic breast change?

Study These Flashcards
A

1) D/c contrceptives/hormone replacement therapy OR switch to lowest possible dose
2) D/c caffiene
3) Reassurance

23
Q

What is Mondor’s Disease?

Study These Flashcards
A

Phlebitis of the throaco-epigastic vein

24
Q

What is the most common carcinoma in women by indidence?

25
What are the risk factors for breast cancer?
1) Female 2) Age (post-menopausal) 3) Early menarche/late menopause 4) Obesity 5) Atypical hyperplasia 6) First-degree relative with breast cancer
26
What assessment tool can be used to calculate risk in breast cancer?
Gail risk assessment score (1.67= high risk)
27
What clinical features suggest hereditary breast cancer?
1) Multiple-first degree relatives with breast cancer 2) Tumor at early age (45 y/o or pre-menopausal) 3) Multiple tumors in single patient Also, - Triple receptor negative under 60 y/o - Personal history of ovarian cancer - Family history of male breast cancer (BRCA2)
28
What is the most common type of breast cancer?
Invasive ductal carcinoma
29
What is the difference between Grade 1, 2, and 3 breast cancer?
Grade 1= well differentiated/ slow growing Grade 2= moderate Grade 3= poor differentiation/fast growing
30
What type of cancer is Tamoxifen used to treat?
ER+
31
What type of cancer is Trastuzumab (Herceptin) used to treat?
HER2/Neu+
32
What is the receptor status of most invasive breast cancer?
ER/PR+ and HER2/neu-
33
What is inflammatory breast cancer?
Carcinoma that invades the dermal lymphatics causing the classic "Peau d' orange"
34
How is inflammatory breast cancer distinguished from acute mastitis?
No response to antibiotics
35
How can inflammatory breast cancer diagnosis be confirmed?
Punch biopsy
36
Clinically, what is important about medullary, mucinous, papillary, and tubular breast cancer?
Better prognosis that invasice ductal carcinoma
37
What is Paget's Disease?
DCIS that extends to the nipple *Presents as nipple ulceration and erythema
38
What is the current screening recommendation for breast cancer?
- 25-40 y/o Q1-3 year clinical breast exam | - 40+ y/o is annual breast exam and mammography
39
Define BI-RADS 1.
Normal
40
Define BI-RADS 2.
Benign finding
41
Define BI-RADS 3.
Probably benign--recommend short follow-up
42
Define BI-RADS 4.
Suspicious for malignancy
43
Define BI-RADS 5.
Strongly suggestive for malignancy
44
Define BI-RADS 6.
Imaging patient with known malignancy
45
What is the single most important prognositc factor in breast cancer?
Axillary lymph nodes
46
What is the sentinal lymph node?
First lymph node in the chain of drainage
47
What has sentinal lymph node biopsy prevented?
Lymphedema
48
What should you do if the sentinal lymph node is positive?
Axillary lymph node dissection
49
What is the current recommendation for surgical intervention for breast cancer?
Overall survival is equal between lumpectomy + radiation compared to radical mastectomy *Recurrence rate is higher with lumpectomy, but can be prevented with appropriate surveillance
50
Is contralateral prophylaxtic mastectomy recommended for patients without BRCA mutations?
No--there is no advantage

OB/GYN (19 decks)

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