all tingz breasts

Question 1

Digital breast tomosynthesis (DBT) vs Full field digital mammography (FFDM) mammogram

Answer 1

DBT is 3D and has less false positives, FFDM is 2D & better with calcifications

Question 2

what happens if theres an abnormality on DBT or FFDM

Answer 2

diagnostic mammogram

Question 3

best time of month to do mammogram

Answer 3

2nd week of menstrual cycle (in follicular phase)

Question 4

2 standard views in mammography

Answer 4

CC view and MLO view

Question 5

If PE and imaging findings do not provide clear information or reassurance about the etiology of a new palpable mass, what now?

Answer 5

biopsy

Question 6

when do you use MRI with breast stuff

Answer 6

screening high risk population

Question 7

if patient needs a biopsy but breasts are too thin what can you use

Answer 7

US

Question 8

if recalled for calcifications & over 30 with screening, what test is next

Answer 8

diagnostic mammogram only

Question 9

if recalled regarding masses & over 30 what tests are next

Answer 9

diagnostic mammogram + targeted US

Question 10

if recalled from screening results but under 30, what test is indicated

Answer 10

targeted US

Question 11

when to use screening vs diagnostic mammogram

Answer 11

screening is only if asymptomatic
if symptomatic, then use diagnostic mammogram + US

Question 12

the second most common cancer in US women & the leading cause of cancer death in women 20-59

Answer 12

breast cancer

Question 13

most common RF for breast cancer

Answer 13

age!

Question 14

anything that prolongs estrogen exposure including having first kid at late age & higher breast density are risk factors for?

Answer 14

breast cancer

Question 15

which precursor lesion has highest risk for breast CA

Answer 15

LCIS

Question 16

4 signs of breast cancer

Answer 16

• lump in breast or size/shape changes
• nipple changes
  *non-healing breast ulcer
• swollen lymph nodes

Question 17

how often should average risk women aged 50-74 get breast cancer screening?

Answer 17

Q 2 yrs

Question 18

for higher risk younger women, which screening modality is preferred

Answer 18

MRI after US if lesion isnt visualized on US

Question 19

BIRADS findings of ___ will need a biopsy

Answer 19

4-5

Question 20

cancer only in breast & local lymph nodes; goal of tx is curative

Answer 20

non metastic (stage 1-3)

Question 21

TNM means?

Answer 21

tumor size
nodes
metastasis

Question 22

besides stage, what is the second major factor in prognosis?

Answer 22

the cancer subtupe

Question 23

what determines CA subype

Answer 23

tumor cell expression of Estrogen receptor, progesterone receptor & HER2 receptor

Question 24

hormone receptor positive tumors (ER,PR) is ____ prognosis for breast cancer

Answer 24

good– this means tumor growth is stimulated by estrogen

Question 25

3 poor prognostic factors

Answer 25

larger than 5cm – high recurrence
high S phase fraction & DNA index
oncogene HER2

Question 26

best test to clarify solid vs cystic mass

Answer 26

US

Question 27

Hx of nipple discharge or abnormal imaging
Usually not palpable; diagnosed by core biopsy; no increase in cancer risk

Answer 27

intraductal papilloma

Question 28

Nontender, smooth, round, mobile breast mass in otherwise normal exam; can squish around
Solid appearance on US

Answer 28

fibroadenoma

Question 29

Generalized breast pain/swelling, often cyclic sx w/ cycle (otherwise normal exam); lumpy or rope-like

Answer 29

fibrocystic breast syndrome

Question 30

Breast pain or generalized/diffuse tenderness
NO skin changes, discharge, lump

Answer 30

mastalgia

Question 31

2 RF for mastalgia vs fibroadenoma

Answer 31

mastalgia– reproductive age & dense glandular tissue
fibroadenoma– younger age & size may increase with pregnancy

Question 32

benign mass where tx includes Reassurance, Well fitting bras, no underwire; OTC pain meds for sx

Answer 32

mastalgia

Question 33

benign mass where tx includes Excision only if large or bothersome; Aspiration of simple cyst prn

Answer 33

fibroadenoma

Question 34

benign mass where Imaging not usually needed; supportive care

Answer 34

fibrocystic breast syndrome

Question 35

swollen, red, painful breasts in first 3 mo of breast feeding; most caused by S. aureus

Answer 35

lactational mastitits

Question 36

periductal mastitis is inflammatory condition of subareolar ducts that can happen in men esp smokers; tx with keflex, bactrim or diclox

Answer 36

nonlactational mastitis

Question 37

rare benign inflammatory breast dz of unknown etiology; self limiting

Answer 37

granulomatous mastitis