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Women's Health Clin med > Benign breast disorders > Flashcards

Benign breast disorders Flashcards

1
Q

What nodes receive most of the drainage from the breast

A

Axillary (sentinel)

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2
Q

Which nodes are most commonly involved with breast cancer metastases

A

Axillary nodes

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3
Q

What is the top cause of fever in post partum females

A

Mastitis

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4
Q

What are some risk factors for mastitis

A

first time nursing
difficulty nursing
oversupply of milk
maternal stress/fatigue
illness of mother or child
cracks / nipple sores

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5
Q

What is mastitis

A

infection of the breast

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6
Q

What is the most common cause of mastitis

A

S. aureus

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7
Q

What are some s/sx of mastitis

A

unilateral
indurated, erythematous, edematous tender area on breast
fever

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8
Q

How do you diagnose mastitis

A

Mostly clinical
*if persistent -> culture MIDSTREAM milk sample

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9
Q

How do you treat mastitis

A

breast feeding
bedrest
breast massage
supportive bra
pain control (NSAIDs / Tylenol)

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10
Q

What is the first line abx for mastitis

A

Dicloxacillin (7-14 days)

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11
Q

What is the treatment for mastitis if there is a PCN allergy or MRSA is suspected

A

Clindamycin

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12
Q

What are the risk factors for breast abscess

A

material age (>30)
Primparity
gestational age +41weeks
mastitis

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13
Q

What are some causes of a breast abscess that are unrelated to breast feeding

A

DM
Smoker
hidranitis suppurativa
trauma
*inflammatory complication

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14
Q

What is the primary cause of a breast abscess

A

worsening of mastitis
*S. aureus

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15
Q

What are the s/sx of a breast abscess that are different from mastitis

A

palpable fluctuant mass
+/- spontaneous drainage

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16
Q

What is diagnostic for a breast abscess

A

aspiration (possible I&D)

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17
Q

What antibiotics can be used for breast abscess

A

Bactrim
Clindamycin
Doxycycline

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18
Q

What is a galactocele

A

Milk retention cyst

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19
Q

When do galactoceles commonly present

A

typically 6-10 months after lactation

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20
Q

What is the most common lesion in lactating women

A

galactocele

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21
Q

What are the s/sx of galactocele

A

palpable mass that is soft, non-tender, and mobile
*no systemic symptoms

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22
Q

What is the imaging test of choice for galactocele

A

Ultrasound

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23
Q

How can you make a definitive diagnosis of a galactocele

A

Needle aspiration

24
Q

How can you treat a galactocele

A

warm compress (should resolve on own)
*if not = aspiration

25
Q

What are breast cysts often associated with

A

larger spectrum of fibrotic disease

26
Q

When do fibrocystic diseases typically peak

A

30-50 y/o

27
Q

What are breast cysts most commonly related to

A

hormones (overproduction of estrogen)

28
Q

What is the best initial test for breast cysts

A

US
*helps differentiate between cystic vs solid

29
Q

What will a cyst look like on US

A

round, well circumscribed, anechoic

30
Q

When should mammography be considered with breast cysts

A

> 35years old

31
Q

What are the 3 types of breast cysts

A

simple
complicated
complex

32
Q

What are the properties of a simple breast cyst

A

smooth, thin, regular walls
completely fluid filled
always benign

33
Q

What are the properties associated with complicated breast cysts

A

some debris but not real solid and no thick walls

34
Q

What are the properties of complex breast cysts

A

irregular or scalloped with thick walls
some solid components and debris
may be malignant

35
Q

How do you get a definitive diagnosis for breast cysts

A

FNA
(cytology and culture)

36
Q

What is the treatment for a simple breast cyst

A

aspiration +/- excision
*no monitoring necessary

37
Q

How do you treat complicated breast cysts

A

Aspiration +/- cytology/culture
Re-image and/or bx q6m x 2 yr

38
Q

How do you treat complex breast cysts

A

FNA or excision biopsy
follow-up q6m x 2yr

39
Q

What are 2 types of fibrocystic changes that can occur

A

Non-proliferative
proliferative

40
Q

What are the characteristics of non-proliferative fibrocystic changes

A

no epithelial hyperplasia in ducts
No increase in risk for Brest cancer development

41
Q

What is the most common presenting system with fibrocystic changes in the breast

A

Mastalgia that is exacerbated by menstruation, chocolate, caffeine

42
Q

How do you assess fibrocystic changes in women >35

A

mammogram

43
Q

How do you assess fibrotic changes in women <35 and why

A

US because the breast tissue is too dense for mammo

44
Q

What are the treatment options for fibrocystic breast changes

A

reassurance and a supportive bra

*if more severe, can use tamoxifen

45
Q

What is the most common benign tumor of the breast

A

fibroadenoma

46
Q

Who usually gets fibroadenoma

A

usually females <30
*higher rates in those who took OCP before age 20

47
Q

Which breast tissue is usually effected by fibroadenomas

A

stromal and epithelial cells

48
Q

Where on the breast do fibroadenomas present

A

Can be bilateral
*upper/outer quadrant most common

49
Q

When are core needle biopsies needed for fibroadenomas

A

suspicious lesion
high risk women
rule out malignancy

50
Q

Which patients will have a fibroadenoma removed

A

Rapid growth
uncertain diagnosis
size >2cm
patient request

51
Q

When are intraductal papillomas general present

A

35-55years old

52
Q

What are the risk factors for intraductal papilloma

A

contraception
hormone replacement therapy
lifelong estrogen exposure
+FH

53
Q

What is an intraductal papilloma

A

benign tumor of ductal epithelial cells

54
Q

Where are solitary papillomas most common

A

central and posterior to the nipple
*effects central duct

55
Q

What type of discharge can occur with an intraductal papilloma

A

bloody or clear and spontaneous

56
Q

What type of imaging can be done to show a filling defect in the milk ducts

A

Galactography

57
Q

What is the treatment for an intraductal papilloma

A

Lumpectomy due to the high risk of becoming cancerous

Women's Health Clin med (13 decks)

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