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Setha: Reproductive Clinical Assessment > Bates/Lecture > Flashcards

Bates/Lecture Flashcards

1
Q

What breast mass is common between ages 15-25 during puberty and young adulthood?

A

Fibroadenoma

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2
Q

How does a fibroadenoma present?

A

Round, disc-like, or lobular usually single, but may be multiple mass that may be soft, but usually firm that is well delineated and very mobile, non-tender without retraction sign

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3
Q

What breast mass is common between ages 30-50 that repress after menopause except with estrogen therapy?

A

Cyst

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4
Q

How does a cyst present?

A

Single or multiple round mass that is soft to firm, usually elastic, well delineated, mobile, often tender, without retraction sign

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5
Q

What breast mass is seen between the ages of 30-90, but most common over the age of 50?

A

Breast cancer

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6
Q

How does breast cancer present?

A

Usually single mass with an irregular or stellate shape that is firm or hard, not clearly delineated from surrounding tissues, fixed to skin or underlying tissue, usually non-tender, retraction sign may be present

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7
Q

Fibrosis that is caused by shortening of the tissue that produces dimpling, changes in contour, and retraction deviation of the nipple on the breast

A

Retraction signs

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8
Q

What are some causes of retraction signs?

A

Breast cancer, fat necrosis, and memory duct ectasia

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9
Q

What position should the patient be in to look for skin dimpling?

A

Arms at rest, during special positioning, and on moving or compressing the breast

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10
Q

What are the retraction signs?

A
  • Skin dimpling
  • Abnormal contouring
  • Nipple retraction/deviation
  • Edema of the skin
  • Pagets disease of the nipple
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11
Q

What produces edema of the skin?

A

lymphatic blockage

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12
Q

What sign is seen with edema of the skin?

A

peau d’orange sign: thickened skin with enlarged pores usually seen first in the lower portion of the breast or areola

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13
Q

What is seen with abnormal contours?

A

Any variation in the normal convexity of each breast compared one side with the other. Special positioning may be useful

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14
Q

What is a retracted nipple?

A

Flattened or pulled inward that may also be broadened and feels thickened

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15
Q

What can happen if nipple involvement is radially asymmetric?

A

It may deviate in a different direction from its normal counterpart, typically toward the underlying cancer

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16
Q

Uncommon form of breast cancer that starts as a scaly, eczema like lesion that may weep, crust, or erode with possible breast mass

A

Paget’s disease of the nipple

17
Q

What can Paget’s disease present with?

A

invasive breast cancer or ductal carcinoma in situ

18
Q

When to suspect Paget’s disease?

A

persisting dermatitis of the nipple and areola

19
Q

What is the lifetime risk of breast cancer?

A

1 in 8!

20
Q

What is the most important risk factor with breast cancer/

A

AGE!

21
Q

Other risk factors for breast cancer?

A
  • family history
  • breast tissue density
  • biopsy showing atypical hyperplasia
  • Unopposed estrogen exposure (e.g. early menarche, late menopause, no pregnancies)
  • radiation to chest wall
22
Q

What percentage of women with breast cancer have no identifiable risk factors?

A

> 50%

23
Q

What is important to know with a family history of breast CA?

A

Age of diagnosis

24
Q

What screening is done for a young patient with increased risk factors for breast cancer?

A

Start screening early - usually 10 years prior to the age that the family member was diagnosed - MRI every other year with mammograms in off years

25
Q

Diagnostic testing for a patient below 30 years old with nipple discharge/breast mass

A

Start with ultrasound only because younger breast tissue is more dense and harder to see things on mammogram

26
Q

Diagnostic testing for a patient over 30 years old with nipple discharge/breast mass

A

Ultrasound and mammogram usually ordered

27
Q

What age range do you start mammography?

A

40-50 years old - usually annually

28
Q

Risks of mammograms

A

False positives, over diagnosis

29
Q

When can you chose to stop giving patients mammograms for screening?

A

If life expectancy is less than 10 years

30
Q

What gene mutations can you suspect with breast cancer?

A

BRCA1 & BRCA2

31
Q

What can a positive family history for BRCA1 & BRCA2 include?

A
  • 1st degree relative w/ breast CA BEFORE age 50
  • ≥2 individuals in same lineage w/ breast CA
  • 1st degree relative w/ ovarian CA
32
Q

Recommendations for CBE

A

20-40 years old, every 2-3 years

>40, annually

33
Q

What are you looking for in CBE?

A
  • Lump
  • Pulled in nipple
  • Dimpling
  • Dripping
  • Redness/rash
  • Skin changes
34
Q

What lymphatics should be palpated during CBE?

A

Infraclavicular, supraclavicular, and central deep axilla

35
Q

How should the patient be positioned on the table for inspection of the breasts?

A

Patient seated

36
Q

4 positions that the patient needs to be in during breast inspection

A
  • Arms at sides
  • Arms over head
  • Hands pressed against hips
  • Leaning forward
37
Q

What position on the table should the patient be in during palpation?

A

Patient supine

38
Q

Where are 60% of breast cancers found?

A

Upper outer quadrant

39
Q

What characteristics do you need to describe if you find a breast mass/lump?

A
  • location (by quadrant or clock, w/ centimeters from nipple)
  • size
  • shape
  • consistency
  • tenderness
  • mobility

Setha: Reproductive Clinical Assessment (1 decks)

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