Normal and Abnormal Breast Exam Flashcards
(50 cards)
Where does most of the glandular tissue exist in the female breast?
The upper outer quadrants
What are the 2 most common routes for metastasis in the breast?
Ipsilateral lymph node and Internal mammary nodes
What are the 4 congenital anomalies of the breast?
Absence of the breast
Accessory breast tissue along the milk line
Extra nipples (polythelia)
Accessory breast (polymastia)
What are the 2 most common breast complaints?
Breast pain and apparent mass
What are 2 risk factors for development of breast cancer (in terms of onset/cessation of menarche/menses)?
Early menarche (12> y/o)
Late cessation of menses (>55 y/o)
What are some common risks for breast cancer? (8)
Never breast fed Recent and long-tern use of oral-contraceptives Post-menopausal obesity H/O endometrial or ovarian cancer Alcohol consumption Increased height High socioeconomic status Ashkenazi Jewish heritage
Palpable breast masses always get…
A biopsy (FNA/core/excisional)
Mammography is able to detect… (2)
Lesions about 2 years before they become palpable
Inapparent masses of <1 cm
At what age is mammography best?
> 40 y/o
What is breast ultrasonography most useful in evaluating?
What age group is most appropriate?
Inconclusive mammogram findings
Young women (<40 y/o) and others with dense breast tissue
What are 2 unique functions of breast ultrasonography?
Allows for differentiation between cystic and solid lesions
Guidance when performing a core needle biopsy
Under which scenarios (3) would a breast MRI be appropriate?
In adjunct with mammography for suspicious masses
Post-cancer diagnosis for staging evaluation
Women at risk for breast cancer (BRCA mutations, etc.)
FNAB is useful for:
Determining solid vs. cystic masses
What kinds of fluids from FNAB would indicate mammography/US?
Bloody fluid should be sent for cytology and followed with mammography/US
Clear fluid does not require further evaluation
What should be done after FNA with cystic masses?
Return to clinical breast exam in 4-6 mo. if cyst completely disappears with aspiration
If cyst reappears or does not fully resolve, diagnostic mammogram/US and biopsy are indicated
How many samples are needed in a core biopsy? How big should they be?
3-6 samples about 2 cm. long
When does cyclic mastalgia begin and end?
It begins at the luteal phase and ends after onset of menses
What is non-cyclic mastalgia?
It is not associated with the menstrual cycle and may include tumors, mastitis or cysts or with some medicines
What medications are associated with non-cyclic mastalgia? (3)
Anti-depressants
Anti-hypertensives
Hormonal meds (OCPs)
What are 3 extra-mammary causes of mastalgia?
Chest wall trauma
Shingles
Fibromyalgia
What is the only FDA approved treatment for mastalgia?
What are its side effects?
Danazol
Menstrual irregularities, benign intracranial HTN, changes in blood sugar, deepening of voice, abnormal hair growth, weight gain
What 2 drugs may help in mastalgia?
Oral contraceptives
Depo Provera
What lifestyle modifications may help mastalgia symptoms? (6)
Properly fitting bra Weight loss Exercise Decreased caffeine intake Vit. E supplementation Evening of primrose oil
Nipple discharge is usually _______, but can be a sign of _______ or _______
Usually benign, but can be a sign of an endocrine disorder or cancer
