Bates Chapter 10 - The Breast & Axillae Flashcards
The anatomical landmarks for the breast are:
Clavicle and 2nd rib down to 6th rib and sternum to midaxillary line
The axillary tail of breast tissue is called the:
Tail of Spence
The three different types of tissue in the breast that vary with age are:
1) Glandular tissue
2) Fibrous connective tissue
3) Adipose tissue
What do you call tissue, often mistaken for a mole, that grows along the “milk line” and has no pathological significance?
A supernumerary nipple
Lymphatics from most of the breast drain toward the:
Axilla
What are 4 groups of lymphatics that drain the arm and breast?
1) Central (palpable most frequently)
2) Lateral
3) Subscapular
4) Pectoral
What are the 3 common or concerning symptoms in the breast?
1) Breast lump or mass
2) Breast pain or discomfort
3) Nipple discharge
When is the best time to do a breast self exam?
5-7 days after onset of menses, when estrogen stimulation is at it lowest
What do you need to know if your patient reports a breast lump?
1) Location
2) How long has it been present
3) Has there been any change in size
4) Does it vary with cycle
5) Is there change in contour (dimpling, swelling, puckering)
6) Is there discharge (describe) if yes, is it unilateral or bilateral
What do you call the inappropriate discharge of milk-containing fluid in males or females?
Galactorrhea
Of the 3 common concerning symptoms in the breast, which one results in a cancer diagnosis most frequently?
Breast cancer occurs in 11% of women with a breast lump or mass
What is a breast lesion likely to be that presents as a smooth, rubbery, round, mobile and non-tender character?
Fibroadenoma
What is a breast lesion likely to be that presents as a soft to firm, round, mobile character? These may be tender.
Cyst
What is a breast lesion likely to be that presents as a nodular, rope-like texture?
Fibrocystic changes
What is a breast lesion likely to be that presents as irregular, firm, mobile or fixed to surrounding tissue?
Cancer (until proven otherwise)
Which breast lesions are more common in the 15-25 year old age group?
Fibroadenoma
Which breast lesions are more common in the 25-50 year old age group?
Cysts, fibrocystic changes and cancer
What are common breast lesions in the pregnant or lactating female?
Lactating adenomas, cysts, mastitis and cancer
What is the lifetime risk of developing breast cancer in a female born in the US today?
1 in 8 (12%)
What ethnic group has a higher incidence of breast cancer before age 45?
African American
What is the most important risk factor for breast cancer?
Age
List some modifiable risk factors for breast cancer:
1) Postmenopausal obesity
2) Use of HRT
3) Alcohol ingestion
4) Physical inactivity
5) Choosing not to breast-feed
6) Type of contraception
List some non-modifiable risk factors for breast cancer:
1) Family history
2) Breast tissue density
3) Proliferative lesions with atypia on biopsy
4) Duration of unopposed estrogen exposure related to early menarche
5) Age of first full-term pregnancy
6) Late menopause
7) History of radiation to the chest
What percentage of breast cancer occurs in males?
1%
What are risk factors for male breast cancer?
1) BRCA2 mutations
2) Obesity
3) Family history of male or female breast cancer
4) Testicular disorders
5) Work exposure to high temperatures and exhaust emission
What are factors that increase the relative risk for breast cancer in women?
1) Female
2) Age
3) BRCA1 and/or BRCA2
4) Two or more first degree relatives with breast cancer (diagnosed at early age)
5) Personal history of breast cancer
6) High breast tissue density
7) Biopsy-confirmed atypical hyperplasia
What are three well-used breast cancer risk assessment tools?
Gail risk model - >50 and doing mammograms
Claus risk model - for high risk women
BRCAPRO - for high risk women
The risk of breast cancer in those who have BRCA1 mutations is:
The risk of breast cancer in those who have BRCA2 mutations is:
57%
49%
What is DCIS? LCIS?
Ductal carcinoma in situ
Lobular carcinoma in situ
What are the two common selective estrogen receptor modulators (SERMs) used in breast cancer?
Tamoxifen and raloxifene
What is the name of the disease that can cause rashes or ulcerations on the breast?
Paget’s disease
What to assess and record in a breast nodule:
1) Location (by quadrant or clock and cm from nipple)
2) Size (in cm)
3) Shape
4) Consistency
5) Delimitation (well circumscribed or not)
6) Tenderness
7) Mobility (in relation to structures)
What is a sweat gland infection called?
Hydradentitis suppurativa
What do you call a deeply pigmented, velvety, axilla that may or may not be malignant?
Acanthosis nigricans
