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RDS Test 2 > B8.034 Fibrocystic Breast Mass > Flashcards

B8.034 Fibrocystic Breast Mass Flashcards

1
Q

screening recommendations from ACR for average risk women 40-75

A

lifetime risk <15%
annual screening with either mammogram or digital breast tomosynthesis
breast US may be appropriate

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2
Q

screening recommendations from ACR for intermediate risk women 40-75

A

lifetime risk 15-20%
personal history of breast cancer, lobular neoplasia, or atypical ductal hyperplasia
annual screening with either mammogram or digital breast tomosynthesis
breast US or MRI may be appropriate

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3
Q

screening recommendations from ACR for high risk women 40-75

A

lifetime risk >20%
BRCA mutation or untested first degree relative
history of breast irradiation (10-30 years of age)
annual screening with mammogram, digital breast tomosynthesis, or breast MRI
breast US may be appropriate

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4
Q

risk factors for breast cancer

A

age: increased risk with increased age
gender: breast cancer rate in females is 100x that of males
race: highest in whites
weight/height: higher BMI, higher risk in postmenopausal women

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5
Q

relevant PMH to breast cancer risk

A

things that contribute to estrogen exposure over time

  • menarche
  • menopause
  • pregnancy
  • breast feeding
  • DES exposure
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6
Q

relevant social history to breast cancer risk

A

alcohol use
smoking
night shift work

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7
Q

family history relevant to breast cancer risk

A

fam history of breast cancer
in utero exposure to DES
inherited mutations

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8
Q

benign breast mass on imaging

A

round, oval or circumscribed
equal or low density on mammography
homogenously hypoechoic or isoechoic solid mass

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9
Q

malignant breast mass on imaging

A 
irregular shape
ill-defined or spiculated margins
high density on mammography
nonparallel orientation
posterior acoustic shadowing
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10
Q

most common benign breast findings

A 
fibroadenoma
cyst
galactocele
fat necrosis
breast abscess
fibrocystic changes
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11
Q

fibroadenoma characteristics

A

most common
women 15-35
benign solid tumors containing glandular as well as fibrous tissue

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12
Q

fibroadenoma on physical exam

A

well-defined, solid mass that is mobile

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13
Q

fibroadenoma on US

A

well defined mass with benign features

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14
Q

cyst characteristics

A

fluid filled round or ovoid mass

common in women 35-50

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15
Q

cyst on physical exam

A

widely variable - can be smooth, firm or could be a collection of smaller masses that are poorly defined

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16
Q

cyst on imaging

A

ultrasound best way to delineate

17
Q

fat necrosis characteristics

A

usually after trauma or surgery
difficult from a malignancy on physical exam
-irregular borders, adherent to underlying tissue

18
Q

imaging of fat necrosis

A

mammography

may need to be biopsied to confirm not malignant

19
Q

nonproliferative fibrocystic changes

A

cells are normal in number and size

no increased risk for cancer in the future

20
Q

examples of nonproliferative fibrocystic changes

A 
fibrocystic changes
fibrocystic disease
chronic cystic mastitis
mammary dysplasia
simple breast cysts
21
Q

proliferative fibrocystic changes without atypia

A

cells are normal in size but increased in number

slight increase in risk for future breast cancer (1.5-2x the general population)

22
Q

examples of proliferative fibrocystic changes without atypia

A 
ductal hyperplasia
intraductal papillomas
sclerosing adenosis
radial scars
fibroadenomas
23
Q

atypical hyperplasia

A

cells are increased in number and are not normal

moderate increased risk of breast cancer (>2 times the general population)

24
Q

management of atypical hyperplasia

A

recommend risk reduction - yearly mammogram, avoid hormones, etc.

25
Q

examples of atypical hyperplasia

A

atypical ductal hyperplasia (ADH)

atypical lobular hyperplasia (ALH)

26
Q

differential for breast tenderness

A

galactocele
mastitis
breast abscess

27
Q

galactocele

A

cystic collection of retained milk, usually from an obstructed duct

28
Q

imaging for galactocele

A

US

29
Q

treatment of galactocele

A

drainage

30
Q

mastitis

A

localized inflammation of the breast that is associated with fever, myalgias, breast pain, and redness

31
Q

mastitis on physical exam

A

erythematous, tender area on breast, patient may be febrile

32
Q

treatment for mastitis

A

warm compresses
express milk frequently
DO NOT stop breast feeding

33
Q

breast abscess

A

similar causes as for mastitis

less common in breastfeeding mothers

34
Q

breast abscess on physical exam

A

discrete area of tenderness with fluctuance

35
Q

breast abscess on imaging

A

US if necessary

36
Q

treatment of breast abscess

A

antibiotics

may need I&D

37
Q

how to counsel a patient with dense breast tissue

A

increased risk of breast cancer: 4-5x
makes it difficult for radiologists to interpret mammograms
some recommend patients get supplemental screening with US and/or breast MRI

RDS Test 2 (24 decks)

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