Thursday - breast diseas clinical - Onello Flashcards Preview

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Flashcards in Thursday - breast diseas clinical - Onello Deck (30):
1

why do men have nipples

until week 6, development is about the same in m/f.
gland development is due to placental hormones

2

polythelia
polymastia
athelia
amastia
thelarche

too many nips
too many boobs
no nips
no boobs
onset of secondary breast development ~12yo

3

tanner staging 1-5
breast

1 - preadolecent - elevated, no glandular tissue or increased pigmentation

2 - glandular tissue. nip and breast are single mound

3 - increased glandular. increased diameter and pigmentation

4 - nipple and areola form mound above breast

5 - nipple protrudes more

4

tanner staging 1-5
female genitals

1 - no pubic hair
2 - strait hair between labia
3 - more hair, gets darker
4 - hair is dense and curled
5 - more abundant - may go to thigh

5

tanner staging 1-5
male

1 - no hair
2 - light hair, scrotum becomes more textured
3 - hair goes to penis. testes and penis larger
4 - more hair, curling. glans gets bigger
5 - hair goes to thighs

6

gynecomastia causes

normal development usually

kleinfelters
testicular feminization
hormone tumor
hyper/o thyroid
cirrhosis
drugs
obesity

7

breast feeding is more common in:

weathy
eductaed
white
non-smoker

8

continuing breastfeeding

less than 35% are exclusively breast feeding @ 4 mo

recommended for 6mo

9

choosing treatment for sore breast

lactMed website
- says Dicloxacillin is safe

10

history q's on breast exam

duration (pain/discharge)
change over time
relationship to menses
fam hx
gyn/endo hx

11

breast exam

good/bad findings

inspect supine
skin changes
discharge?
clavicular and axillary nodes
masses?

fine - smooth, mobile, well demarcated

bad - firm, irregular, fixed, skin thethering, ulceration, edema, nipple scaling, contour change

12

bi-rads

breast imaging reporting and data system
category 0-6
0- incomplete
1 - negative routine
2 - benign finding
3 - probably benign finding - short f/u
4 - suspicious --> biopsy 23-33% risk
5 - highly suggestive - biopsy, 95% risk
6 - known malignancy

13

Ultrasound for breast screening

best for 30 yo or younger

14

fibroadenoma vs cyst

cyst is anechoic
- lots of through transmission behind cyst

15

MRI for breast advantages

disadvantages

sensitive for small changes
good for dense breasts
used to determine if need surgery/type

takes long time
expensive
non-specific
can't see calcifications

16

SCINTIMAMMOGRAPHY

uses Tc99m - concentrates in mitochondria

best for palpable lesions

not used for screening

17

PET scan

metabolic activity
shows vascularization/ox consumption

expensive

18

race differences in breast cancer

highest in whites
lowest in hispanics

19

Fibroadenoma

benign. 20-30 y/olds
smooth round, mobile, affects by menses, usuall painless

hyperplastic of single duct

10% go away spontaneously

20

cystadenoma phylloides

painless. cellular stroma, nuclear atypis, mitotic figures

excise with wide margins

21

Abcess

usually staph or strep

22

cyst

fluid filled, mobile round, non-tender

watch for 2-3 mo. aspiration

23

trauma

usually cant recall
fibrotic scar/calcification - need tissue diagnosis
tx = watch it

24

fibrocystic changes

common
usually bilateral
increase size and pain near menses

25

lipoma

fatty
well defined
semi-firm, non-tender

take it out

26

mammary duct ectasia
discharge

periductal fibrosis -->inflammation. usually thick grey and black
benign
self limiting
unilateral

tx = surgical
dx = ultrasound

27

discharge
intraductal papilloma

wart-like
usually not palpable
serous/bloody discharge
40-50y/o

28

fine needle aspiration pros cons

fast, painless, cheap, no mark, little chance of infxn, immediate results

less acurate
can't use with implants
I don''t know what she means by these:
in situ vs. invvasive
palpable lesion
cytotechnologist

29

core needle biopsy pros cons

basicaly same as fine needle.

cons
less acurate
not complete description of tumor

30

excisional biopsy

accurate
complete info about tumor
rare false -
may be treatment

cons
expensive
invasive/painful
time to heal
more risk of infection