Brainscape's Knowledge GenomeTM

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


See full index

Endo/Repro II Test 1 > 4. The NL and ANL Breast > Flashcards

4. The NL and ANL Breast Flashcards

1
Q

What are some of the risk factors for breast cancer?

A
    • Age (50YO)
    • No term pregnancies
    • Never breastfed
    • Recent and long-term use of OC’s
    • Postmenopausal obesity (increased converion of andeostenedione => estrone)
  6. Alcohol (2-4 drinks/week = increased risk of dying)
    • Hx of atypical hyperplasia, endometrial/ovarian cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why does early periods (< 12) and late cessation of period ( >55) increase risk of breast cancer?

A

Because longer exposure to estrogen

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

Why is high breast tissue density increase risk of breast cancer?

A

More dense = less likely detected = diagnosed later

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

Do shorter or taller people have a higher risk of breast cancer?

A

Taller

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

What type of people have an increase risk of breast cancer?

A
  1. High SES
  2. Askenazi Jewish heritage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to perform PE of breasts?

A
  1. Evaluate:
    1. Breasts
    2. Axilla
    3. Chest wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnostic tests for breasts

A
  1. Mammogram
  2. US
  3. MRI
  4. FNA
  5. Core biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What diagostic tests would you perform if a pt has a palpable mass?

A
  • Biopsy; either,
    1. FNA (fine needle aspiration)
    2. Core biopsy
    3. Excisional
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mammograms are best in women of what age; how often?

A

40 YO or older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  • What is a mammogram?
  • What do we look for on mammogram?
A
  • Screening and diagnostic tool used to detect lesions 2 years BEFORE they are palpable.
  • Detects
    1. Densities/calcifications
    2. Masses less than 1cm.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When/how is a mammogram performed for screening/diagnostic purposes?

A
  1. Screening if no complaint/concerns;
    1. Take 4 images
    2. Can be done by standard radiograph vs digital enhacement
  2. Diagnostic in women w/ a complaints/palpable mass or to adjunct an abnormal screening mammogram
    1. Check contralateral breast @ same time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ultrasounds are performed when:

A
  1. Inconclusive mammogram
  2. Best for young women (age <40) and others w/ dense breast tissue
  3. Need guidance when performing a core needle biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do we look for on US?

A
  • Differentiates between cystic vs. solid lesions ANDDDD solid tissue within or adjacent to a cyst that may be malignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

American College of Ob/Gyn (ACOG) recommendations for:

  1. Mammograms
  2. Clinical exams
  3. SBE (self-breast exam)
  4. SBA (self-breast awareness)
A
  • Annually after 40YO
  • 20 -39 (q 1-3 years); after 40 (annually)
  • Do for high-risk patients
  • Recommended
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is MRI useful for evaluating the breasts?

A
  1. Adjunct to diagnostic mammography if suspicious masses
  2. Staging a post-cancer diagnosis
  3. Women at high risk for breast cancer (BRCA carriers)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Fine needle aspiration (FNA) biopsy determines if the mass is _______

A

Solid vs cystic;

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

What is the next best step if fine needle aspiration (FNA) of a breast mass:

  1. Contains clear vs. bloody fluid?
  2. If the cyst reappears or does not go away?
A
  1. Clear = no further evaluation

Bloody = send to cytology and diagnostic mammogram/US

  1. Diagnostic mammogram/US & biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is core needle biopsy of the breast used for; how many samples taken?

A
  • Get 3-6 samples about 2cm long tissue is retrieved from larger solid masses to diagnose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 2 most common breast complaints?

A
  1. Breast pain (Mastalgia)
  2. Breast mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 3 types of benign mastlagia (breast pain)?

A
  1. Cyclic breast pain = usually cystic; starts at luteal phase of menstrual cycle and ends after onset of menses
  2. Noncyclic breast pain = usually tumors, mastitis, cysts and can be assoc. w/ some meds (anti-depressants/HTNs, hormonal meds (OCP’s))
  3. Extramammary breast pain = chest wall trauma, shingles, fibromyalgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the only FDA approved treatment for benign mastalgia (breast pain) and what are the AE’s?

A
  • Danazol
  • AE’s =
    • Menstrual irregularities
    • Benign intracranial HTN
    • Alters blood sugar
    • Deepens voice
    • Unusual hair growth and weight gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some recommendations for symptom relief of benign mastalgia?

A
  1. Properly fitting bra
  2. Lose weight
  3. Exercise
  4. ↓ caffeine intake
  5. Vit E & evening of primrose oil
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

______ is an off-brand treatment for mastalgia that can cause what side effects?

A
  1. Selective estrogen receptor modulator (SERM), tamoxifin
    1. DVT
    2. Endometrial hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should we worry about when we see nipple discharge?

A
  1. Usually benign could be sign of endocrine disorder or cancer
25
Q

Non-spontaneous, non-bloody (can be clear, green or yellow) and bilateral nipple discharge is most consistent with what?

A
  1. Fibrocystic changes
  2. Ductal ectasia
26
Q

Milky discharge from pregnancy indicates:

A
  1. Childbearing
  2. Hyperprolactinemia
  3. Hypothyroidism
  4. Medications (OCs/psychotropics)
27
Q

_______ nipple discharge is CONSIDERED CANCER until proven otherwise.

What kind of cancer and if not cancer, what else could it be?

A
  • Bloody
  • Intraductal carcinoma or invasive ductal carcinoma
  • Benign intraductal papilloma
28
Q

Bloody nipple discharge

  • Evalulate = ________
  • Cure = ______
A
  • Evaluate = breast ductography
  • Cure = excise duct
29
Q

What are the 3 categories of benign breast masses?

A
  1. Non-proliferative
  2. Proliferative w/o atypia
  3. Proliferative w atypia
30
Q

What are the types of non-proliferative benign breast masses?

A
  1. Fibrocystic changes
  2. Cysts
  3. Adenosis
  4. Lactation adenomas
  5. Fibroadenomas
  6. Galactocele
31
Q

Describe the following non-proliferative benign breast masses:

  1. Fibrocystic changes (how commonly seen in NL breast)
  2. Cysts
  3. Adenosis
A
  1. Fibrocystic changes: Dilation of lobules => form cysts; cysts rupture and scar and inflame; seen in 50% of NL breasts
  2. Cysts = dilation of lobules
  3. Adenosis = Lobular growth w/ ­ # of glands
32
Q

Describe the following non-proliferative benign breast masses:

  1. Lactation adenomas
  2. Fibroadenomas
  3. Galactocele (secondary infection can cause what?)
A
  1. Lactation adenomas: occur d/t hormones
  2. Fibroadenomas: solid, rubbery, mobile and usually solitary that are usually 2-4cm (but can grow up to 15cm)
  3. Galactocele: cystic dilation of duct filled w/ milky fluid that occurs near time of lactation.
    1. Secondary infection can produce acute mastitis
33
Q

Most common benign tumor in female breast?

-When does it usually occur?-

A
  • Fibroadenoma
  • Late teens- early 20s
34
Q
  • Concerns for malignancy of breast masses (5)
A
  1. > 2 cm in size, immobile and firm
  2. Poorly defined margins
  3. Skin dimpling/retraction/color changes
  4. Bloody nipple discharge
  5. Ipsilateral lymphadenopathy
35
Q

What are the types of proliferative benign breast masses WITHOUT atypia? (4)

How are they usually found?

A

Usually not palpable and found on imaging.

  1. Epithelial hyperplasia
  2. Sclerosing adenosis
  3. Complex sclerosing lesions (radial scar)
  4. Papillomas
36
Q

Descibe the following proliferative benign breast masses W/O atypia?

  1. Epithelial hyperplasia
  2. Sclerosing adenosis
  3. Complex sclerosing lesions (radial scar)
  4. Papillomas:
A
  1. Epithelial hyperplasia: overgrowth of cells that line ducts
  2. Sclerosing adenosis: increased fibrosis of tissue within lobules
  3. Complex sclerosing lesions (radial scar): tubules trapped in dense stoma surrounded by radiating arms of epithelium
  4. Papillomas: intraductal growth that can cause serous or serosanguinous discharge typically seen in W 30-50
37
Q

Which type of benign breast mass is an intraductal growth typically seen in women 30-50 y/o and causes serous or serosanguinous discharge?

A

Papillomas

38
Q

What is proliferative lesions with atypia?

Types?

A

NL epithelium that lines ducts/lobules is replaced by malignant cells, forming a CIS. BM is intact, cannot metastasize

  1. Lobular carcinoma in situ (LCIS)
  2. Ductal carcinoma in situ (DCIS)
39
Q

What is not a precursor to breast CA but RF for developing breast CA?

A

LCIS

40
Q

What is DCIS?

Puts women at risk for _______.

A
  • Ducts are filled w/ atypical epithelial cells
  • Developing invasive dz or recurrence of DCIS
41
Q

How are LCIS and DCIS treated?

A
  1. Excision
  2. Then, treat with SERMs.
42
Q
  • Breast cancer is the most common malignancy in women besides _____ cancer; 2nd leading cause of cancer deaths in US
A

skin cancer

43
Q

Increased mammogram screening has ______ incidence of breast cancer.

A

increased

44
Q

Who is at greatest risk of breast cancer?

(age and race)

A

White women over 50

45
Q

Difference between BRCA1 and BRCA2?

If you had one, which one would you rather have?

A
  1. BRCA1— in ½ of early onset breast cancers and 90% of hereditary ovarian cancers
  2. BRCA2—~35% of early onset breast cancers and much lower risk of ovarian cancer
46
Q

Radiation for what increases risk to breast cancer?

A
  1. Hodgkines disease
  2. Enlarged thymus
47
Q

Using the Gail Model-Breast Cancer risk tool, which women are considered high risk and how should they be managed?

A
  1. Women w/ 5-year risk of 1.7% or more
  2. Counseled on prophylactic therapy (chemoprevention, mastectomy, oophorectomy)
48
Q

70-80% of all breast cancers are what type and where does it spread?

A

Ductal

Spread: regional LN

49
Q

Which type of breast cancer is more likely to be multifocal and/or bilateral?

A

Lobular

50
Q

______ is a superficial skin lesion of the nipple and makes up 3% of breast cancers.

A

Pagets disease

51
Q

What makes up swelling and redness of underlying skin and induration of surrounding tissues and makes up 1-4% of breast cancer?

A

Inflammatory Breast Cancer

52
Q

What should be used in addition to staging to determine treatment of breast cancer?

A
  1. Presence of estrogen and progesterone receptor (positive finding)
  2. Present of Her2/neu oncogene
53
Q

Which 2 surgical options for breast cancer have equivalent outcomes?

A
  1. Lumpectomy w/ radiation
  2. Mastectomy
54
Q

______ has the WORST prognosis and is found in 20-30% of all invasive cancers.

A

Her2/neu (oncogene)

55
Q

What type of therapy is used in ALL stages because it reduces the rest of reoccurancy by 1/2 and death by 30%?

A

Adjuvant therapy

  1. Chemotherapy = kills all cancer cells
  2. Hormonal therapy (tamoxifen)
  3. Aromatase inhibitors (arimedex, femara)
  4. Trastuzumab (herceptin)
56
Q

Which drug can be used for Her2/neu-positive breast cancers; but what are the AE’s?

A
  • Trastuzumab
  • AE’s: heart failure, respiratory problems, serious allergic rxns
57
Q

Which adjuvant therapy is used in premenopausal therapy vs postmenopausal?

A
  • Premenopausal = hormonal therapy (tamoxifen) is a EST ANT that reduces risk in other boob as well
  • Postmenopausal= aromatose inhibitors (arimedex/femara) prevents production of estrogen
58
Q

What is the recommended timeline for treatment follow-up for breast cancer; when do the majority of reoccurrences happen?

A
  • During the first 2 years after diagnosis: every 3-6 months
  • After first 2 years: annually
  • Most reoccurrences happen within first 5 years after tx
59
Q
A

Endo/Repro II Test 1 (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions