Benign Breast Disease Lecture Powerpoint

Question 1

Mastoplasia

Answer 1

Ropy thickening of breast tissue often in upper outer quadrant persistent thru menstrual cycle

Question 2

Galactorrhea

Answer 2

Abnormal breast discharge not necessarily milk

Question 3

Gynecomastia

Answer 3

Swelling of breast tissue in boys or men caused by an imbalance of horomones estrogen and testosterone

Question 4

Cooper’s ligaments

Answer 4

Fibrous septa that extend from skin to underlying pectoralis fasciae forming triangular lobules radially around the nipple, often when invaded by breast cause dimpling of the skin

Question 5

Lymphatic drainage of the breast

Answer 5

• 75% axillary

- remaining 25% to internal mammary vessels and direct lymphatics to mediastinum

Question 6

Breast tenderness 3-4 days prior to menses is due to….

Answer 6

….increased levels of estrogen and progesterone that cause cell proliferation and water retention

Question 7

Where do most breast cancers start?

Answer 7

Terminal lobular ductal units composed of myoepithelial and epithelial cells

Question 8

3D breast digitial tomosynthesis/ 3D mammography

Answer 8

A CT like type of digital mammogram that is highly detailed and views breast in slices, unfortunately still considered expeerimental by many insurance companies

Question 9

When a woman has implants, what kind of breast exam does she need?

Answer 9

Diagnostic for any remaining tissue in the implant

Question 10

Proper steps to take for all mammography screening

Answer 10

• Screening mammo
• If abnormal, diagnostic mammo
• Breast ultrasound
• Biopsy

Question 11

Breast Imaging Reporting and Database System (BI-RADS) scale

Answer 11

0 - wasn’t diagnostic due to external error
1 - continue regular screening if >40yrs, its negative
2 - benign, continue regular screening if >40yrs
3 - likely benign, recommend 6 month follow up
4 - suspicious abnormality, do a biopsy just to be safe
5 - likely cancer
6 - def cancer

Question 12

Breast cancer screening is unneccisary in patients….

Answer 12

…75 or older, or bilateral mastectomy

Question 13

Of the 2 screening guideline bodies, ACS and USPSTF, which do we follow regarding breast cancer?

Answer 13

ACS

Question 14

Severe mastodynia treatment

Answer 14

• Tamoxifen (anti estrogen)

- Goserelin (push into menopause)

Question 15

Topical mastodynia treatment

Answer 15

Diclofenac (solaraze)

Question 16

Fibrocystic breast changes

Answer 16

General term for benign breast changes that may include mobile lumps or pain but entail poorly defined symptoms and etiology

Question 17

Diagnostic testing for fibrocysstic changes of the breast

Answer 17

Image directed core needle biopsy - remove a sample of breast tissue

Question 18

Galactocele

Answer 18

Well circumscribed round milk filled cyst usually found in the central breast, thought to be due to spoiled milk buildup, treated easily with aspiration

Question 19

Fibroadenoma

Answer 19

Firm freely mobile solid benign solitary breast mass 2nd most common tumor in the breast

Question 20

What age group is firboadenoma most common?

Answer 20

Woen 15-35, arises in late teens and druing reproductive years

Question 21

Phyllodes tumor

Answer 21

Rare rapidly growing bulky tumors that distort the breast, may ulcerate thru skin due to pressure necrosis, wide exicsion required unless metastasis has occurred

Question 22

Intraductal papilloma

Answer 22

Benign growth within the ductal system that presents as bloody nipple discharge (that isn’t cancer), most common cause of unilateral nipple discharge***, relieved upon expression

Question 23

Diagnosis for an intraductal papilloma

Answer 23

Ductogram

Question 24

Fat necrosis

Answer 24

Bruised or dead tissue within the breast often due to trauma forming stellate lesions

Question 25

Fat necrosis diagnosis

Answer 25

Mammography showing stellate area of distortion with calcification

Question 26

Fat necrosis treatment

Answer 26

Excisional biopsy

Question 27

Galactorrhea common causes

Answer 27

• breast stimulation
• trauma
• estrogen withdrawal or estrogen therapy
• OCP’s
• Pituitary tumors (keep this in back of head)
• PCOS

Question 28

How to treat a plugged duct

Answer 28

Moist heat and manual expression

Question 29

Mastitis and abscess

Answer 29

Most often caused by a staph infection entering thru a cracked nipple in 9-33% of lactating women

Question 30

Mastitis and abscess treatment

Answer 30

Continue frequent breast feeding, antibiotics, I&D if necessary

Question 31

Paget’s disease

Answer 31

Appearance of a psoriatic rash that begins on the nipple and spreads off the areola and into the skin of the breast

Question 32

Peau d’orange

Answer 32

Edema of the skin strongly resembling dimpling of an orange of the breast caused by lymphatic blockage or mastitis

Question 33

Mastitis and abscess symptoms

Answer 33

-Fatigue, malaise, myalgias, headache, fever, unilateral warmth tenderness, erythema

Question 34

How do you alleviate breast pain around menstruation?

Answer 34

• Supportive bra
• Eliminate caffeine
• Topical cream
• NSAIDS

Question 35

For Galactorrhea, what is the first course of action?

Answer 35

Serum for prolactin, do NOT MRI initially

Question 36

Fibrocystic breast disease age and symptoms

Answer 36

Most common in the 40’s, breast tenderness, smooth tense masses, small mobile lumps,

Question 37

Fibroadenoma age and symptoms

Answer 37

Freely mobile solid benign breast mast, common in women 15-35 arise in late teens in reproductive years

Question 38

Fibroadenoma age and symptoms

Answer 38

Freely mobile solid benign breast mast, common in women 15-35 arise in late teens in reproductive years