Onello: Breast Diseases Flashcards

(47 cards)

1
Q

milk line

A

accessory nipples develop along here

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2
Q

polymastia

A

extra breast

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3
Q

polythelia

A

multiple nipples

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4
Q

amastia

A

abscence of breat nipple and possibly pectoralis

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5
Q

thelarche

A

breast development

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6
Q

age of thelarche

A

AA 12.1

caucasians-12.6

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7
Q

MC of gynecomastia in boys

A

NORMAL development d/t hormonal changes

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8
Q

no pubic hair

A

I

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9
Q

straight hair extending between labia

A

II

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10
Q

pubic hair increased in quantitiy, darker, typical female triangle

A

III

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11
Q

pubic hair more dense, curled, adult distribution

A

IV

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12
Q

abundant, adult pattern hair that can extend onto medial aspect of thigh

A

V

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13
Q

who breastfeeds more?

A

wealthier
more educated
caucasian
non smoker

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14
Q

how long should you breast feed

A

exclusive for 6 mos

continue for 1 year

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15
Q

why do many women stop breast feeding

A

insufficient milk supply

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16
Q

key cultural pt about breastfeeding

A

breastfeeding is a social behavior–we fail/learn how to breastfeed from those around us

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17
Q

common problems encountered during breastfeeding

A

does NOT fit western lifestyle
hard time feeding after maternity leave
not EASY thing

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18
Q

environmental contaminants in human breast milk

A

foods- chemicals
hygiene- lotion
pesticides/herbicides

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19
Q

pharmacologic contaminants in breast milk

A

OTC

prescription

20
Q

key questions to ask during a breast exam

A
duration
change over time
relationship to menses- PERIODS STARTING EARLY, MENSES ENDING LATE
nipple discharge
presence of pain
family hx- BRCA1, MATERNAL
gyne-endo hx- NULLIPAROUS, 1ST CHILD AFTER 30, RADIATION EXPOSURE
previous cyst aspirations
hx of atypical breast hyperplasia
21
Q

increases risk of breast cancer

A

nullparious

OR

if 1st child born after 30, radiation

22
Q

clinical breast exam

A
inspect breasts seated and supine
skin changes
palpate entire area of breast
nipple discharge
supraclavicular/axillary lymph areas
cofirm a palpable mass?
be aware of normal structures that "mimic"
23
Q

ideal time in pre-meopausal to do a breast exam

A

1st week post menses

24
Q

MASS:
smooth
mobile
well demarcated

A

Reassuring

**cancer usually DOESN’T HURT

25
``` Mass: firm ill defined margins irregular fixed ```
worrisome
26
does breast cancer hurt?
not usually
27
lump/contour change--> cancer pulls the breast skin tethering nipple inversion ulceration nipple SCALING> Paget disease of the breast edema/peau d/orange
Worrisome findings on a breast exam
28
do we recommend self breast exams?
Not recommended
29
peau d orange is usually a sign of
inflammatory breast cancer
30
most common complaints (pain, nipple discharge, skin changes, bresat lumpts) are...
BENIGN
31
BENIGN freely moving and painless* hyperplastic process of a single duct 10% disappear spontaneously
fibroadenoma
32
why does cystosarcoma phylloides need histological differentiation
25% are malignant
33
common infection caused by staph/strep often requires I and D and Abx
abscess
34
what do you do w/ a breast cyst
aspirate> release fluid often curative
35
trauma may cause peripheral calcifications in the breast how shoiuld you tx? what should you consider?
watchfull waiting unless infected physical abuse?
36
lumpy bumpy breasts discrete masses usually bilateral increase in size/tenderness prior to menses
fibrocystic changes
37
thick, grey, black discharge
mammary duct ectasia
38
wart like growth in lining of mammary duct near nipple + Serous+/- BLOODY discharge in 45-50 year old
intra-ductal papilloma surgically remove it
39
should be done for any PALPABLE LESIONS
FNA core needle bx excisional bx
40
suspicious masses on imaging that should be biopsied
1. needle localization | 2. stereotactic bx
41
is a breast exam alone sufficient to reliably make a final dx when a breast mass is detected?
NO!
42
how should women <30 be evlauated
NOT mammograms | use US
43
1st line after breast exam?
mammography
44
when should you do mammogram?
controversial | after 50 annually
45
should you do a mammo in a pt w/ implants?
you bet
46
do most women w/ breast cancer have RFs?
NO 3/4 dont! **possibly related to lifetime estrogen exposure
47
RF for bresat cacaner?
``` DCIS/LCIS age YOUNGER menarche first live birth AFTER 30 relatives w/ BC WHITE ```