Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

6. Women's Health > 1- Breast Disorders > Flashcards

1- Breast Disorders Flashcards

1
Q

What views are used for screening and diagnostic mammography?

A

Screening = 2 craniocaudal (CC) + 2 mediolateral oblique (MLO)

Diagnostic = CC + MLO + more views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What technique is used for mammography in women who have breast implants?

A

Implant displacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is timely eval with mammography important?

A

R/o cancer and relieve pt anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the indications for diagnostic testing with US? (breast disorders) (5)

A

Inconclusive MMG results, young women, dense breast tissue, differentiation between solid and cystic mass, guiding for tissue core-needle biopsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When is an MRI used for diagnostic testing? (breast disorders)

A

Detecting breast CA in high risk women, staging disease in women w/ breast CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When is MRI diagnostic testing NOT recommended? (breast disorders)

A

Eval of a breast mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is important to note about use of MRI that could have contraindications?

A

IV gadolinium dye used

(check BUN and creatinine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What diagnostic test is the acceptable initial method for evaluating a mass with low pretest probability of CA and is useful in determining if a palpable lump is a simple cyst?

A

Fine-needle aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What diagnostic test is used to obtain samples from larger, solid breast masses?

A

Core-needle biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 types of possible surgical biopsy? (breast disorders)

A

Incisional (portion of mass) and excisional (take entire mass)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are 2 of the more important history questions to ask when evaluating breast sxs?

A

A/w menstrual cycle, RFs that increase likelihood of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is mastalgia and what are its etiologies/ classifications?

A

Breast pain; cyclical, non-cyclical, extra-mammary

(non-cyclicalrelated to internal anatomical changes like injury, surgery, cyst)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the characteristics of cyclical pain (mastalgia)? (4)

A

Luteal phase, bilateral, diffuse, fibrocystic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What type of mastalgia may be unilateral or focal, and may be caused by meds (hormonal contraceptives, HRT, SSRIs, Spironolactone)?

A

Noncyclical

(ex. large, pendulous breast causes ligamentous pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pt who is younger than 30 yrs presenting with focal breast pain should proceed with what diagnostic studies?

A

Targeted US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pt who is older ≥ 30 yo and presents with focal pain should proceed with what diagnostic studies?

A

Targeted US and MMG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is 1st line treatment for mastalgia if normal findings on exam and imaging? (4)

A

Reassurance, physical support, compresses, analgesics (acetaminophen/ NSAIDS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is 2nd line treatment for mastalgia (only if failed 1st line for > 6 mos)?

A

Danazol or Tamoxifen for 1-3 mos

(caution w/ SEs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Woman who is lactating presents with hard, red, tender, swollen area of one breast. VS show fever. What are you concerned for?

A

Mastitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most common etiology of mastitis?

A

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is an important ddx for mastitis that you do not want to miss?

A

Inflammatory breast CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the tx for mastitis?

A

Dicloxicillin or cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What pt edu should be provded for a woman with mastitis?

A

Continue breastfeeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the management for breast abscess if there is evidence of skin compromise?

A

I+D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is important to consider in the management of benign vs malignant breast masses?

A

PE cannot distinguish, need imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What characteristics are indicative of a benign breast masses? (5)

A

Discrete margins, no skin changes, smooth, soft to firm, mobile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What characteristics are indicative of a malignant breast masses? (4)

A

Poorly defined margins, possible skin changes, hard, immobile/ flexed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is defined as a fluid-filled round or ovoid mass?

A

Breast cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pt presents with smooth, firm (due to fluid), mobile mass that is well-defined on palpation and +/- tenderness. What are you concerned for?

(can also be ballotable- not firm)

A

Breast cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A cluster of cysts may palpate as what?

A

Ill-defined mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the management for simple breast cysts?

A

Typicall no intervention unless:

  • Sx, then FNA
  • Recurrent, then repeat imaging
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the management for complicated breast cysts (< 1% risk of malignancy)?

A

FNA or follow w/ imaging q 6 mos x 2 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the management for complex breast cysts (1-23% risk of malignancy)?

A

Bx + possible surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is defined as a benign, solid tumor containing glandular and fibrous tissue?

A

Fibroadenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pt presents with round, well-defined, mobile mass that is firm and non-tender. Hx of increasing in size during pregnancy and w/ estrogen use. What are you concerned for?

A

Fibroadenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the management for a fibroadenoma?

A

Core needle bx +/- surgical excision/ cryoablation

OR
If benign features on US- 3-6 mo repeat CBE and US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If a fibroadenoma increases in size, what is the management?

A

Excision (r/o malignancy)

38
Q

What should be considered with rapid growth of a fibroadenoma?

A

Phyllodes tumor

39
Q

What is defined as a fibroepithelial tumor classified as benign, borderline or malignant?

A

Phyllodes tumor

40
Q

Pt presents with suspicious breast mass. What is the next step?

A

Dx MMG and directed US → bx

41
Q

Pt presents with indeterminate lesion/ breast mass and is ≥ 30 yo. What is the management?

A

Dx MMG w/ or w/o directed US

42
Q

Each duct of the breast drains what?

A

A separate portion of the breast

43
Q

What type of nipple discharge is typically spontaneous, unilateral, from a single duct, bloody, serous, clear, or a/w a mass?

A

Pathologic discharge

44
Q

What is the most common cause of patholgic nipple discharge?

A

Intraductal papilloma

(others: duct ectasia, CA, infection)

45
Q

What type of nipple discharge is typically bilateral, from multiple ducts, and associated with stimulation?

A

Physiologic discharge

46
Q

What is the most common cause of physiologic nipple discharge?

A

Galactorrhea

(others: med related, neurogenic stimulation)

47
Q

What characteristics of nipple discharge indicate a surgical referral?

A

Single duct or bloody

48
Q

What are the strongest RFs for breast CA?

A

Female gender and advancing age

49
Q

The following are RFs for what?

Female gender, advancing age, BRCA 1 and 2 genetic mutations, hx of DCIS, first birth > 30 yo or nulliparity, FH of breast/ ovarian CA, early menarche, late menopause, high BMI, postmenopausal hormone therapy

A

Breast CA

50
Q

What are BRCA1 and BRCA2 genes are how are they linked to breast and ovarian CA?

A

Tumor suppressors, mutation linked to CA

51
Q

What are the management options if BRCA + (mutation present)?

A

Increased surveillance, chemoprevention (Tamoxifen if > 35 yo), surgical prevention (prophylactic mastectomy)

52
Q

Does BRCA (-) (mutation not present) mean the a female with NOT get breast CA?

A

NO

53
Q

What are the methods of breast cancer screening and what is the most highly recommended?

A

“Breast awareness” (most recommended), clinical breast exam (CBE), screening MMG

54
Q

When is the best time to perform a clinical breast exam (CBE) and what are the key features to the exam?

A

In follicular phase; systematic approach and cover entire area

55
Q

What are the breast CA MMG screening recommendations for average risk women?

(no personal/ family hx of breast CA, no genetic mutation, no chest chest radiation < 30 yo)

A
  • Consider @ 40-49 yo
  • Screen all women @ ≥ 50 yo
  • Stop screening @ 75 yo
  • Frequency: every 1-2 yrs
56
Q

When is annual breast CA screening w/ MRI recommended?

A

High risk of breast CA and high sensitivity of MRI

57
Q

How is breast CA classified?

A

Anatomical location (lobular or ductal), hormone receptivity (E and P), HER2 expression

58
Q

How does breast CA most commonly present clinically?

A

Palpable mass

(+/- skin changes, nipple discharge)

59
Q

Breast lesions with malignant cells that have not penetrated the basement membrane of the mammary ducts or lobules is defined as what?

A

Noninvasive (in situ) breast CA

60
Q

What are the 2 types of noninvasive (in situ) breast CA?

A

Lobular (LCIS) and ductal (DCIS)

(ductal localized inside mammary ducts)

61
Q

What type of breast CA is treated as a malignancy because it has the potential to develop into invasive CA?

A

DCIS

62
Q

What type of breast CA appears on MMG as clustered pleomorphic calcifications, has a PE WNL and can be multifocal or multicentric?

A

DCIS (ductal)

63
Q

What type of breast CA does not become an invasive CA if left untreated?

A

LCIS (lobular)

64
Q

What type of breast CA presents with PE and imaging WNL, is usually an incidental finding but can be an indicator for increased risk of invasive carcinoma?

A

LCIS (lobular)

65
Q

What is the treatment for DCIS? (ductal)

A
  • Breast- conserving surgery w/ radiation vs mastectomy +/- sentinel lymph node bx
  • Adjuvant hormone therapy if E+P positive (Tamoxifen and Arimidex)
66
Q

What is the treatment for LCIS? (lobule)

A
  • Typically none recommeded (not a true CA)
  • Lifelong surveillance
  • Chemoprevention (Tamoxifen, Arimidex)
  • Bilateral prophylactic mastectomy
67
Q

What is the most common breast malignancy (80%)?

A

Infiltrating ductal carcinoma (IDC)

68
Q

How does infiltrating ductal carcinoma (IDC) typically present?

A

Palpable mass or MMG abn
“Oh damn, not good”

69
Q

What type of breast CA usually presents as a palpable mass or MMG abn, is more apt to be bilateral, and is usually hormone receptor positive?

A

Infiltrating lobular carcinoma (ILC)

“You’re lucky”

70
Q

Stellate lesions, irregularly shaped mass, spiculation, pleomorphic calcifications and anatomical distortion of MG + taller than wide on US is indicative of what?

A

Invasive breast carcinomas

71
Q

Pt presents with unilateral scaly, raw, vesicular or ulcerated lesion that begins on the nipple and spreads to the areola +/- blood discharge. Pt notes hx of pain, burning and pruritis before the lesions appeared. What are you concerned for?

A

Paget Disease of the Breast (PDB)

(rare cause of breast CA but majority have underlying breast CA)

72
Q

What type of breast cancer is very aggressive and presents clinically as pain w/ rapidly progressing, tender, firm, enlarged breast, skin warm, thickened, peau d’orange appearance, and erythema?

A

Inflammatory breast CA (IBC)

73
Q

Inflammatory breast CA (IBC) is typically considered very aggressive with almost all having what?

A

Lymph node involvement, 1/3 with distant metastasis

74
Q

What is the primary location for lymphatic spread of breast CA?

A

Axillary

(also can spread to internal mammary nodes, supraclavicular w/ late disease)

75
Q

What are the most common locations for hematogeneous spread of breast CA?

A

Lung and liver

(can also go to bone, ovaries, brain)

76
Q

What is the management for breast CA?

A

Surgery (BCS- lumpectomy, mastectomy), radiation, chemo, endocrine therapy

77
Q

The following characteristics of breast CA determine what?

Tumor size, lymph node involvement, mets, E+P status, HER2 status, oncotype dx breast recurrence score, BRCA status

A

Surgical management

78
Q

What surgical management of breast CA is defined as part of the breast containing the CA is removed w/ or w/o selective sampling of axillary nodes?

A

BCS (breast conserving surgery) = lumpectomy

79
Q

What is typically considered to be the appropriate treatment for stage I or II breast CA due to decreased morbidity and comparable survival/ recurrence rates compared to more invasive procedures?

A

BCS with post-op radiation

80
Q

What is removed in a simple (aka total) mastectomy?

A

Entire breast including nipple and areola

81
Q

What is removed in a modified radical mastectomy?

A

Entire breast including nipple and areola + axillary lymph nodes

82
Q

What is removed in a radical mastectomy?

A

Entire breast, lymph nodes, pec muscle

(rarely performed)

83
Q

Radiation is almost always used (more commonly after surgery) in the treatment of breast CA. WHat are the 2 types?

A

External beam and brachytherapy

(radiation to breast, chest wall, regional LN/ axillary)

84
Q

When is chemotherapy included in the management of breast CA?

A

Primary and metastatic breast cancers, (+) lymph nodes, high oncotype dx recurrence scores

85
Q

When is neoadjuvant chemo?

A

Given before surgery to shrink size of tumor

(may allow for breast conservation surgery)

86
Q

What is adjuvant chemo?

A

After surgery, kills CA cells left behind

87
Q

What type of breast cancer is responsive to HT?

A

Estrogen (+) and progesterone (+) breast CA

(as compared to hormone negative CA)

88
Q

What HT drugs are included in the management of breast cancer as a supplement to chemo and radiation?

A
  • SERM- Tamoxifen (if pre-menopausal)
  • Aromatase inhibitors- Arimidex (if post-menopausal)
89
Q

How long is endocrine/ hormone therapy typically given for in the treatment of breast CA?

A

5-10 years

90
Q

What is HER2 and what is it’s association to breast CA?

A

Growth-promoting protein; CA a/w overexpression of HER2

91
Q

What breast CA treatment targets HER2 and when is it effective in combo with chemo?

A

Herceptin; effective in early stage CA’s and metastatic disease

92
Q

When is chemoprevention recommended for breast CA prevention?

A

Asx women aged ≥ 35 w/o a prior dx of breast CA who are at increased risk

Give Tamoxifen or Arimidex/ Raloxifene

6. Women's Health (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions