Boobs Flashcards
Where do breast arise from?
basal layer of epidermis
What type of breast developmement can happen in infants?
unilateral or bilateral enlargement (70%) producing “witches milk”
When do thelarche usually happen?
8 and 13 yrs
breast development in young girls are
less fat more dense
breast development in older adults are
more fat and less dense
What is polythelia?
accessory nipples
What is polymastia
accessory glands
What is the treatment for polythelia?
NONE
usually asymptomatic, excision not required
When does premature thelarche occur?
<8 yr
What is the treatment for premature thelarche?
self limited
monitor body growth, Tanner stage
What is the treatment for breast asymmetry?
NOTHING
can have surgical augmentation or reduction after full breast growth
yearly exams
rule out mass
Treatment for breast hypertrophy?
reduction mammoplasty (until full growth)
What is breast hypertrophy?
extremely large breast
What symptoms come along with breast hypertrophy?
back pain, shoulder discomfort, kyphosis, psychosocial distress
What is tuberous breast?
rare, fascia adheres to the underlying muscle
What is the treatment for tuberous breast?
exogenous HRT (small dose and gradually increase) surgery modification
Describe cyclic mastalgia
usually bilateral, hormonal changes w/menstrual cycle, 1 week prior
Describe non cyclic pain mastalgia
lesions of breast or chest wall
Treatment for cyclic breast pain?
OCP (90%)
NSAID, mechanical support, diet
Describe extramammary pain?
chest wall
spinal and paraspinal disorders
trauma
What causes mastitis?
staph infection
How does mastitis present?
fever, myalgia, leukocytosis, warm, tender
Treatment for mastitis
oral antibiotic (dicloxacillin)
What can nipple discharge?
galactorrhea (consider patho!)
What is the biggest thing that should be considered in galactorrhea?
neoplastic processes
What is the Most common medication that causes galactorrhea?
antipsychotics
What treatment should be given for galactorrhea in a female who wants preggo?
Bromocriptine
Carbegoline
(dopamine agonist)
What imaging should done to check for nipple discharge
ductography
What two things can cause nipple discharge?
intraductal papilloma
Milk duct polyps
Where do breast cyst arise from?
apocrine metaplasia of lobules
What age do cyst incidence usually peak?
40-50yrs old
How is cyst diagnosed?
ultrasound
Treatment for breast cyst?
aspirated if painful
Feel of a breast cyst?
soft, mobile, and smooth
What are the three types of cyst?
simple
complicated
complex
What is the treatment for a complicated cyst?
should be drained, not resolve biospy
Treatment for a complex cyst?
excision is recommended
Composition of fibroadenoma?
glandular and cystic epithethial structures surrounded a cellular stroma
Who is at risk for Fibroadenoma?
adolescents and premenopausal women
feel of a fibroadenoma?
rubbery, mobile, smooth w/ distinct margins
treatment of fibroadenoma?
followed w/o excision (triple test)
What makes up the triple test?
- clinical breast exam
- imaging, mammogram
- biospy
If a fibroadenoma starts to grow what should be done?
removal
feel of a galatocele?
painless mass palpable usually in central portion of breast
A breastfeeding patient could get infected when?
galactocele
Treatment for galactocele?
subsides
What is galactocele?
cystic dilation of a duct or ducts
What causes a fat necrosis?
breast mass develops after blunt trauma, breast surgery, radiation, or injection of foreign substance
Feel of a fat necrosis?
solitary, irregular, ill-defined mass
How is a fat necrosis diagnosed?
imaging and biopsy
similar to fibroadenomas?
phylloides tumor (rare)
Phylloides tumor growth?
fast can be benign, intermediate, malignant
Treatment for Phylloides tumor?
wide local excision
What is the peak age for phylloides tumors?
40yo
The second most common cancer diagnosed?
breast cancer
Second leading cause of death from cancer
breast cancer
What is the lifetime risk of breast cancer?
12.08% (1 in 8)
What is sojourn time?
1mm-1cm before it becomes palpable
When should breast cancer screening start?
@ ~40
When should breast cancer screening end?
75 yrs
What is Paget’s disease?
rare problem on the skin
How is breast cancer staged?
TMN 1-4
What hormonal treatment is used for breast cancer?
Tamoxfen
What is used to check for describe findings in mammogram?
Breast Imaging Reporting and Database System (BI-RADS)
Which BI-RADS causes the biggest anxiety in pts?
Cat 0 (need additional evaluation, further evaluation)
What imaging can be done in young adults with dense breast?
ultrasound
A MRI can be used for screening breast cancer in which group?
women w/ >20% lifetime risk of developing breast cancer
What 3 factors puts a woman at risk of breast cancer?
- BRCA 1 or BRCA 2
- 1st degree relative w/ BRCA
- History of radiation txt to chest between 10-30yr
