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Breast > benign breast dz and random breast cx > Flashcards

benign breast dz and random breast cx Flashcards

1
Q

most common organism of lactational mastitis

A

staph aureus

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2
Q

most common breast mass during lactation

A

galactocele

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3
Q

most common cause of unilateral bloody nipple discharge

A

intraductal papilloma

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4
Q

true or false. in a previously radiated field implant based reconstruction has a lower complication rate and lower failure rate than autologous reconstruction

A

false

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5
Q

what screening regimen is recommended after silicone breast implant to screen for silent rupture?

A

MRI 3 years after placement and then every 2 years after that

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6
Q

rare benign inflammatory breast disease characterized by granulomas on core biopsy and either idiopathic or related to underlying conditions like TB or sarcoidosis:

A

granulomatous mastitis

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7
Q

pathology results: spiculated mass with central sclerosis surrounded by entrapped normal ducts and lobules peripherally

A

radial scar

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8
Q

pathology results: abundant proliferation of both stromal and epithelial contents

A

fibroadenoma

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9
Q

pathology results: fat disruption, lipid-laden macrophages and chronic inflammation

A

fat necrosis

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10
Q

pathology results: increased central cellularity with lobules and intact myoepithelial contents

A

sclerosing adenosis

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11
Q

pathology results: complex and branching fronts lined by epithelial cells that are cuboidal or columnar

A

intraductal papilloma

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12
Q

cause of cyclical breast pain

A

hormone fluctuations due to menstrual cycle

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13
Q

large pendulous breasts can cause pain via stretching of what?

A

Cooper’s ligaments

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14
Q

true or false. women with noncyclic breast pain over age 40 do not need mammography

A

false.

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15
Q

treatment of benign or borderline phyllodes:

A

excise with negative margins; no radiation recommended

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16
Q

location of thoracodorsal neurovascular bundle

A

contains thoracodorsal nerve and thoracoepigastric vein; runs in the mid axilla just inferior to the axillary vein; innervates latissimus dorsi

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17
Q

location and innervation of long thoracic nerve

A

runs parallel to chest wall; innervates serratus anterior

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18
Q

true or false. technetium-99 is contradindicated in pregnancy but methylene blue is safe

A

false

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19
Q

causes and initial work up of galactorrhea:

A

endocrine dysfunction, medications, neurogenic stimulation; initial work up should be checking prolactin and thyroid function

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20
Q

true or false. neoadjuvant chemotherapy should be considered before surgery in advanced breast cancer in men

A

true

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21
Q

absolute contraindications to BCT:

A

2 or more primary tumors in separate quadrants of the breast
persistent positive margins after reasonable surgical attempts
pregnancy when delivery is not imminent (3rd trimester)
hx of prior radiation (therapeutic) to breast such that retreatment would cause excessively high dose
diffuse, malignant appearing calcifications

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22
Q

relative contraindications to BCT:

A

hx of scleroderma or active SLE; large tumor in small breasts that would result in poor cosmesis; very large or pendulous breasts if reproducibility of patient set up and adequate dose homogeneity cannot be ensured

23
Q

true or false. lack of concordance between a mammographic abnormality and pathology results is an indication for surgical excision after core bx

A

true

24
Q

Z011 trial findings:

A

no difference between sentinel lymph node biopsy alone vs axillary lymph node dissection for T1-T2 breast cancer with clinically no lymph node involvement and fewer than 3 positive SNL

25
Q

treatment of DCIS

A

mastectomy or BCT (lumpectomy plus radiation); patients with hormone receptor positive DCIS should get tamoxifen

26
Q

standard of care for atypical ductal hyperplasia

A

excisional biopsy

27
Q

if patient has unilateral single duct nipple discharge and nothing found on imaging:

A

perform duct excision

28
Q

if patient has single duct nipple discharge and has findings on MRI:

A

perform tissue biopsy or repeat exam and imaging in 6 months

29
Q

mammography of fibroadenoma:

A

solid mass with lobulated margins

30
Q

mammography of malignancy:

A

indistinct, spiculated margins or architectural distortion

31
Q

what medication is an option for men with ER/PR positive cancer

A

tamoxifen; aromatase inhibitors do not work as well

32
Q

when is chemotherapy indicated in men with breast cancer:

A

breast cancer >0.5cm and/or any aggressive features

33
Q

bilateral greenish nipple discharge in a young patient is usually caused by____

A

fibrocystic change

34
Q

what do phyllodes tumor stain positive for?

A

vimectin and actin

35
Q

treatment of phyllodes tumor

A

wide excision to negative margins

36
Q

dx of Paget disease of the breast

A

nipple areolar skin biopsy; associated with breast malignancy in majority of cases

37
Q

how is a cellular fibroadenoma distinguished from a phyllodes tumor

A

histologic confirmation

38
Q

true or false. tamoxifen provides breast cancer risk reduction in LCIS and ADH

A

true

39
Q

findings on histopathology of radial scar:

A

fibroelastic coree that pulls and distorts the ducts and lobules; sclerosis, elastosis, and stellate architecture

40
Q

true or false. when ADH or LCIS are detected on core needle bx, surgical excision is recommended b/c it can be difficult to tell the difference between ADH and DCIS on core

A

true

41
Q

true or false. reexcision is necessary for nonpleomorphic LCIS or ADH

A

false

42
Q

true or false. cytology is indicated for FNA of a breast cyst if fluid is bloody

A

true

43
Q

histologic appearance of Paget’s disease of the breast:

A

large cells with pale cytoplasm and prominent nucleoli involving epidermis of the nipple

44
Q

Appearance of simple breast cysts on ultrasound:

A

avascular, anechoic, oval, posterior enhancement and an imperceptible wall

45
Q

Appearance of complex breast cysts on ultrasound:

A

internal echoes or thin septations; thickened or irregular walls; lack posterior enhancement; some risk of malignancy and should be managed with follow up imaging

46
Q

Type of intraductal papilloma that can present with erosion, crusting, or ulceration of the nipple

A

nipple adenoma

47
Q

Most common breast mass in adolescent girls:

A

fibroadenomas

48
Q

True or false. For occult breast cancer of the axilla, there is equivalent survival for axillary disssection plus mastectomy and axillary dissection with radiation

A

true

49
Q

first line treatment of cyclical mastalgia

A

tamoxifen

50
Q

True or false. Sclerosing adenosis confers no increased risk of breast cancer

A

False

51
Q

Most common breast abscess organism

A

Staph aureus

52
Q

True or false. Tamoxifen reduces breast cancer incidence among BRCA 2 patients but not BRCA 1 patients

A

true

53
Q

True or false. Prophylactic mastectomy reduces risk of breast cancer in males with BRCA1

A

false.

54
Q

Biologic effects of tamoxifen

A

weak agonist in nonbreast tissue; competitive antagonist in breast tissue

Breast (2 decks)

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