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breast Flashcards

1
Q

what test differentiates solid and cystic breast masses

A

ultrasonography

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2
Q

bromocriptine, tamoxifen, danazol, vit B6

A

mastodynia

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3
Q

common organisim in breast infection and abscesses

A

staph aureus

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4
Q

significant fever/chills, flu like symptoms, unilateral tenderness

A

mastitis or abscess

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5
Q

how much of breast is affected in mastitis

A

one quadrant

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6
Q

mastitis tx

A

penicillinase resistant- cloxacillin, dicloxacillin, nafcillin; cephalosporin, hot compresses

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7
Q

can a woman still breastfeed with mastitis

A

yes

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8
Q

fibrocystic breast changes occur in what age

A

30-50

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9
Q

what test to order in suspected breast cysts

A

fine needed aspiration both diagnostic and therapeutic. straw colored fluid

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10
Q

most fibrocystic breast changes treated how

A

supportive bra

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11
Q

3 things you can do for fibrocystic changes

A

low salt diet, vit E, HCTZ

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12
Q

fibroadenomas age and race

A

young, black

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13
Q

round, firm, smooth, discrete, mobile, nontender

A

fibroadenoma

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14
Q

fibroadenoma in pt under 25 y.o

A

biopsied

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15
Q

fibroadenoma tx

A

excision

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16
Q

why no mammogram with breast cyst

A

breast tissue too dense

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17
Q

D/D of breast mass (5)

A

fibrocystic d/s, fibroadenoma, mastitis/abscess, fat necrosis, cancer

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18
Q

2 common causes of bloody nipple discharge

A

intraductal papilloma and mammary duct ectasia

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19
Q

what is associated with 5-10% of breast cancer

A

BRCA1 and BRCA2 genes

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20
Q

nulliparity, early menarche, late menopause, long term estrogen, radiation exposure, delayed childbearing

A

associated factors in breast cancer

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21
Q

what makes a woman have an increased risk of breast cancer

A

first degree relative, especially if cancer was premenopausal or bilateral or found in 2 relatives

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22
Q

2 kinds of breast cancer

A

80-85% infiltrating ductal carcinoma; remainder lobular carcinomas

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23
Q

what 2 disorders predispose to breast cancer

A

lobular CIS and atypical ductal hyperplasia

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24
Q

what is paget’s disease?

  • often what underneath
  • % of breast cancers
A

ductal carcinoma presenting as a eczematous lesion of the nipple/areola.
often DCIS or IDC underneath
1% of breast cancer

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25
all invasive lobular carcinomas and 2/3 of ductal carcinomas are what
estrogen receptor positive
26
45-60% of breast cancer occur where | 25% where
upper outer quadrant | under nipple and areola
27
breast cancer race
white
28
single, nontender, immobile, firm mass, ill defined margins
breast cancer
29
common mets of cancer
BLT with pickle: breast, lung, thyroid, prostate
30
increased exposure to estrogen how (3)
early menarche, late menopause, nulliparity
31
axillary nodes matted or fixed to skin
stage III breast cancer
32
ipsilateral supraclavicular or infraclavicular nodes
stage IV breast cancer
33
tests to get for a postmenopausal and premenopausal breast mass
mammogram post menopausal | ultrasonography premenopausal
34
rope like bumpy lumpy breasts
fibrocystic disease
35
ductal carcinoma in situ
possible malignant, cancerous cells within the milk ducts. DCIS puts pt at increased risk of invasive disease
36
invasive ductal carcinoma
malignant and invasive neoplastic cells which have broken out of the milk ducts
37
15% breast cancers
lobular
38
lobular carcinoma in situ
abnormal cells within the lobule. not considered cancer. it puts the pt at an increased risk of developing cancer
39
invasive lobular cancer
cancer cells have broken out of the lobule
40
peau d' orange
orange skin, think breast cancer
41
oncotype DX test
to determine the need for chemo with stage 1 or II hormone receptor positive cancer
42
what stages are most curable with breast cancer
I, IIA, IIB
43
tx for early stage breast cancer
lumpectomy with sentinal node bx
44
tamoxifen for what
estrogen receptor antagonist: women with estrogen receptor positive disease and postmenopausal women
45
breast cancer surgery
modified radical masectomy and partial masectomy with radiation
46
mammogram screening recommendations
annually for age 45-54 | every other year for pts 55
47
imaging for metastatic disease breast
CT and PET
48
what is galactorrhea caused by
pituitary prolactinoma
49
galactorrhea tests (4)
elevated prolactin, b hCG, MRI pituitary/hypothalmus
50
what 2 drugs can lower prolactin
cabergoline and bromocriptine
51
cabergoline and bromocriptine
what 2 drugs can lower prolactin
52
who is gynecomastia seen in (3)
- taller, heavier boys during puberty - elderly - obese
53
6 possible causes of gynecomastia
endocrine issue, chronic liver d/s, chronic kidney d/s, neoplasm, drugs, puberty
54
gynecomastia: describe... - prolactin - testosterone - estradiol - karyotype
- prolactin may be elevated - testosterone low - estradiol may be increased - karyotype: Klinefelter's syndrome
55
good initial test for a suspicious lesion on mammogram
FNA(careful of false positive) or a core needle bx
56
CEA, CA 15-3, or CA 27-29
tumor markers for recurrent breast cancer
57
metastatic breast cancer labs (3)
increased ESR, increased calcium, and increased alk phos(liver and bone mets)
58
what imaging do you order metatstatic breast cancer - 3 tests - 2 other helpful tests
- CXR, CT chest/abdomen/pelvis, brain MRI | - PET and bone scarn
59
increased ESR, increased calcium, and increased alk phos(liver and bone mets)
breast cancer
60
early stage breast cancer tx
sx + irradiation or mastectomy +/- radiation(deep cancer) | must do sentinel node biopsy for eval of axillary nodes
61
locally advanced breast cancer tx
chemo plus medicine; or surgery with sentinal bx
62
stage IV breast cancer tx
radiation and hormonal. mastectomy
63
large tumor size, subareolar location, multifocal tumors, fixation to chest wall, prior radiation to chest wall, involvement of nipple or overlying skin
contraindications to breast conserving therapy(lumpectomy)
64
what occurs in 50% of metastatic breast cancer | - symptom
pleural effusion | edema of the arm

reproductive system (11 decks)

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