Test 1 Flashcards
Invasive Breast Cancer
Most common, discrete, solid mass, malignant cells infiltrate
Paget’s Disease
Rare, eczmetous nipple changes, discharge. Palpable mass.
Inflammatory breast cancer
Rare, rapidly progressing. Skin changes. Mass or no mass.
Carcinoma in situ
Pre=invasive, non-invasive, stage 0. DCIS, LCIS. Confined to ducts or lobes. Can become invasive. Rare to have palpable mass. Slow growing. Manage with lumpectomy/mastectomy and radiation.
DCIS
Ductal carcinoma in situ. Earliest form of BC.
LCIS
Lobular carcinoma in situ. Increased risk of BC later in life.
Breast cancer tx options
Surgery, radiation, chemo, hormone therapy (adjuvant)
Estrogen Sensitive tumor treatment
Estrogen promotes cancer growth. Block estrogen production with aromatase inhibitors (Anastrozole, Letrozole) or block estrogenic affects with SERMs (Tamoxifen, raloxifene). NOT BRACA 1
Breast Conserving Surgery
Lumpectomy (Just tumor), Partial Mastectomy (tumor and some nodes)
Total simple mastectomy
Entire breast is removed, some lymph nodes under the arms
Modified radical mastectomy
Entire breast and most of the lymph nodes removed
Breast Augmentation Screening
MRI better. Implants can obscure lesions. Subpectoral instead of retroglandular. Capsular Contracture common Side effect - less with Sub pectoral.
Rotterdam Critera for PCOS
2 of the following Androgen excess, Ovulatory dysfunction, Polycystic ovaries
PCOS in Adolescents
Androgen excess is key
Treatments for PCOS
Oral contraception and metformin
Critera for Metabolic Syndrome
Waist Circumference > 88cm
Elevated triglycerides >150
BP > 130/85 or active tx
Glucose levels >100 or active tx
Physiology of PCOS
Lack of ovulaton, lack of progestrone, increased androgens, increase in insulin resistance (cause on obese pt), increse in LH (cause in lean pts)
Thatcher criteria for PCOS
Transvaginal ultrasound shows > 12 cystic structures
PCOS Metabolic Panel
Done fasting at day 2-4 of cycle. TSH and Prolactin. LH/FSH ratio. Androgens. Lipid panel, 2 hour glucose tolerance test
LH/FSH Ratio
Usually 1 liklihood of PCOS increases. Hallmark symptom.
Androgen Test PCOS
DHEAS is the marker of the adrenal contribution
Common signs of PCOS
Cycle length >35 days, chronic pelvic pain and PMS
