Monday, 2-27-Normal and abnormal breast (Wootton) Flashcards Preview

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Flashcards in Monday, 2-27-Normal and abnormal breast (Wootton) Deck (32):
1

__ is responsible for growth of adipose tissue and lactiferous ducts

__ is responsible for stimulation of lobular growth and alveolar budding

estrogen

progesterone

2

risk factors for breast CA (laundry list)?

-age
-personal hx of breast CA
-hx of atypical hyperplasia
-high breast tissue density
-1st degree relatives w/ breast CA or ovarian CA
-early menarche (age <12)
-late cessation of menses (age>55)
-no term pregnancies
-never breastfed
-recent and long term use of OCs
-postmenopausal obesity
-personal hx of endometrial or ovarian CA
-EtOH consumption
-Height (tall)
-High SES
-Ashkenazie jews

3

a palpable breast mass qualifies for what?

biopsy --> FNA/core/excisional

4

mammography is best win these women?

40 yrs and older

5

ACOG recommendations for mammography? Clinical exam?

mammo-age 40+ annually

cliical exam-age 20-39=1-3 yrs; age 40+=annually

6

this method is useful in evaluating inconclusive mammogram findings, best for evaluating young women (age <40) and others with dense breast tissue, allows to differentiate between cystic vs solid lesions, and used for guidance when doing core needle biopsy

Ultrasound

7

this method is a useful adjunct to dx mammography in suspicious masses, used post-CA dx for further evaluation of staging, used with implants, and women at high risk for breast CA like BRCA carrieres

MRI

8

__ is useful in determining solid versus cystic masses

FNA biopsy-smaller needle (22-24 gauge)

-clear fluid=no further eval
-bloody=sent for cytology and need dx mammogram/US

9

this method is used to get tissue from larger solid masses for Dx and uses a large needle (14-16 gauge)

core needle biopsy

10

causes of cyclic mastalgia? noncyclic mastalgia? extramammary mastalgia?

cyclic-starts at luteal phase, ends after onset of menses

noncyclic: tumors, mastitis, cysts

extramammary: chest wall trauma, shingles, fibromyalgia

11

only FDA approved tx for mastalgia?


others?

Danazol only FDA approved tx but unpleasant side effects

can also do SERMs, OCs or Depo provera, proper fitting bra, weight loss, exercise, decrease caffeine intake, Vit E supplements

12

concern with bloody nipple discharge?

considered CA until proven otherwise

-concern for intraductal carcinoma or invasive ductal carcinoma

-could be benign intraductal papilloma

-evaluate with breast ductography and requires ductal excision

13

when should you be concerned for malignancy of a breast mass?

- >2 cm in size
-immobile
-poorly defined margins
-firmness
-skin dimpling/retraction/color changes
-bloody discharge
-ipsilateral LAD

14

fibrocystic changes, cysts, fibrosis, adenosis, lactational adenomas, galactocele, and fibroadenomas are what type of breast masses?

Non-proliferative-benign

15

most common tumor in female breast that usually occurs in late teens to early 20s?

fibroadenoma

-solid , rubbery, mobile, typically solitary

16

epithelial hyperplasia, sclerosing adenosis, complex sclerosing lesions (radial scar) and papillomas are what type of breast masses?

Proliferative WITHOUT atypia-Benign

17

__ are intraductal growths seen in women 30-50 yrs old, cause serous or serosanguinous discharge and considered benign, proliferative without atypia

papillomas

18

LCIS and DCIS are what type of breast masses?

Prolfierative lesions WITH atypia

19

tx of both LCIS and DCIS?

both tx with excision and then followed w/tx with SERMs

20

lifetime risk of developing breast CA? lifetime risk of dying from it?

develop=1:8
die=1:28

21

age and race risk factors for breast CA?

majority after 50, white women at greater risk

22

FH and genetic risk factors for breast CA?

1st degree relative, esp if dx under age 40

BRCA1- about 1/2 early onset breast and 90% hereditary ovarian

BRCA2- about 35% early onset breast, much lower risk of ovarian ca

23

this type of breast CA makes up 70-80% of all breast CA, most common in women in their 50s, spreads to regional nodes

Ductal

24

this type of breast CA is 5-15% of breast ca, more likely to be multipfocal and/or bilaterla

lobular

25

__ presents as superficial skin lesion around the nipple (3% of breast CAs)

pagets disease

26

__ breast CA makes up 1-4%, swelling and redness of underlying skin and induration of surrounding tissues

inflammatory breast CA

27

in breast CA tx, use __ status in addition to staging to determine prognosis

receptor

28

this receptor associated with worse prognosis and found in 20-30% invasive cancers

HER2/neu (oncogene)

29

this hormonal tx is an estrogen antagonist, reduces risk of CA in contralateral breast as well

tamoxifen

30

__ inhibitors prevent production of estrogen in postmenopausal women

aromatase (arimedex, femara)

31

__ acts on protein made by HER2/neu

trastuzumab (herceptin)

-side effects: Heart failure

32

tx follow-up of breast CA?

-1st 2 yrs after dx: every 3-6 months
-annually after 1st 2 yrs
-most reoccurences will happen within 1st 5 yrs after tx