Breast Flashcards

1
Q

Patients with ____ classically have symptoms of mastitis that do not improve (or only initially improve)with antibiotics.

A

inflammatory breast carcinoma

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2
Q

Presents with diffuse breast erythema, pain, and edema with skin thickening and dimpling (peau d’orange appearance).

A

inflammatory breast carcinoma

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3
Q

____ is a rapidly aggressive form of breast cancer, and many patients initially have metastatic disease.

A

Inflammatory breast carcinoma

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4
Q

Solitary, well-circumscribed & mobile mass

± Tenderness

A

Breast cyst

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5
Q

Multiple, diffuse nodulocystic masses

Cyclic premenstrual tenderness

A

Fibrocystic changes

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6
Q

Solitary, firm, well-circumscribed & mobile mass

Cyclic premenstrual tenderness

A

Fibroadenoma

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7
Q

After trauma/surgery
Firm, irregular mass
± Ecchymosis, skin/nipple retraction

A

Fat necrosis

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8
Q

Benign papillary tumor arising from breast duct lining

Unilateral bloody nipple discharge (can be non-bloody)

A

Intraductal papilloma

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9
Q

No associated breast mass or lymphadenopathy

Unilateral bloody nipple discharge (can be non-bloody)

A

Intraductal papilloma

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10
Q

Treatment for Intraductal papilloma

A

Mammography & ultrasound

Biopsy ± excision

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11
Q

Most important prognostic factor in breast cancer?

A

TNM staging

Tumor burden is based on TNM staging

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12
Q

Women <30 with complex cyst/mass, recurrent cysts, or solid mass. Next best step in management?

A

Core Needle Bx

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13
Q

Complex cysts seen on Ultrasound.

Next best step in management?

A

Core Needle Bx

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14
Q

Simple cysts seen on U/S. Asymptomatic.

Next best step in management?

A

Observe

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15
Q

Simple cysts seen on U/S. Tender.

Next best step in management?

A

FNA

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16
Q

Persistent or recurrent breast cyst s/p FNA
or
bloody aspirate in aspirate.
Next best step in management?

A

Core Needle Bx

+/- more imaging

17
Q

Sudden-onset unilateral pelvic pain
Nausea & vomiting
± Palpable adnexal mass
U/S → Enlarged ovary with decreased or absent Doppler flow

Diagnosis & Next best step in management?

A

Ovarian Torsion

Laparoscopy with detorsion
or
Ovarian cystectomy
Oophorectomy (if necrotic or malignant)

18
Q

Pt with unilateral breast rash, erythema, and edema. Metastatic disease (axillary lymphadenopathy) is common on initial presentation.

A

Inflammatory breast carcinoma (IBC)

an aggressive breast cancer w/ rapid spread

19
Q

Inflammatory breast carcinoma (IBC) diagnostics to confirm include (2)

A

Core needle breast biopsy
&
Full-thickness skin punch biopsy

20
Q
  1. Unilateral, spontaneous, bloody nipple discharge accompanied by a palpable breast mass and retraction of overlying skin (invasion of suspensory ligaments).
  2. Unilateral bloody discharge without a breast mass. No overlying skin retraction
A
  1. Invasive Ductal Carcinoma

2. Intraductal Papilloma

21
Q

Presents with palpable, fluctuant breast mass with purulent nipple discharge and FEVER

A

Breast abscess

22
Q

Lymphatic drainage from the breast passes primarily to the ___ lymph nodes.

The ____ muscle is the landmark for distinguishing the surgical levels of lymph nodes during dissection.

A

axillary

pectoralis minor

23
Q

Sudden-onset, severe, unilateral lower abdominal pain immediately following strenuous or sexual activity

+ Pelvic free fluid on u/s

A

Ruptured ovarian cyst

24
Q

Fever/chills, vaginal discharge, lower abdominal pain & cervical motion tenderness
± Tuboovarian abscess

25
Amenorrhea, abdominal/pelvic pain & vaginal bleedingPositive β-hCG
Ectopic Pregnancy
26
Breast conserving therapy typically consists of partial ___ and ____ biopsy, followed by whole breast ___ therapy. 
mastectomy (Lumpectomy) sentinel lymph node → axillary LN dissection radiation * Adequate surgical excision requires negative margins.
27
Positive sentinel lymph node biopsy warrants axillary lymph node dissection (typically performed for __ positive nodes). 
≥3
28
___ is sometimes used for cancer SCREENING in high-risk patients (ex: BRCA carrier). 
Breast MRI
29
Patients with bilateral, diffuse, and cyclic breast pain 1. With mass 2. W/o mass
1. Imaging | 2. Observe
30
Patients with unilateral, focal, and noncyclic breast pain 1. With mass 2. W/o mass
1. Core needle Biopsy 2. Imaging to evaluate for cancer. Abn imaging = CN bx
31
 Breast ultrasound is indicated in this patient with ___ breast tissue. 
dense breast tissue | no matter the age!
32
BRCA testing is indicated for FMH of breast cancer in __ 1º relatives (parent, sibling, child) & 1 of whom was diagnosed at age ≤ __. 
≥2 ≤50 *One 2º relative (cousin, aunts, grandparents, nieces, half siblings) with breast cancer diagnosed at age >50 is not an indication