Breast Flashcards
48 yo with Large painless breast lump, no lymphadenopathy, rapidly growing, leaf-like appearance tumor under microscope
Phyllodes tumor- benign tumor that looks like fibroadenoma in imaging
Mastalgia, cyclic pain with menses, clear/white discharge
Fibrocystic Breast disease
A rapid introduction proliferation of cells that leads to necrosis and cellular debris within the ducts. On microscope: solid growth of large, paleo Orphic, high-grade cell’s with central expansile necrosis, mitotic figures, periductal inflammation and fibrosis and coarse microcalcifications
Comedocarcinoma- a type of ductal carcinoma in situ with rapid introduction proliferation of cells
Painless breast mass, skin changes (retraction, dimpling, edema), nipple retraction, bloody discharge, microcalcifications and stromal invasion on biopsy
Invasive ductal carcinoma
<35yo F, presents as a solitary, nontenders, mobile mass, “popcorn” calcification on mammography, biopsy show benign hyperplastic stroma encapsulating ductal tissue
Fibroadenoma
Sometimes palpable, single or multiple lesions with serous or bloody nipple discharge, biopsy. Show a central, branching, fibrovascular core with surrounding myoepithelial and epithelial cells
Intraductal papilloma
Painless breast nodule with microcalcification and speculations on mammogram and malignant cels in lobules and monomorphic cells in single rows referred to as “Indian file” pattern on biopsy
Invasive lobular carcinoma
Drug with Increased risk of endometrial hyperplasia? Why?
Tamoxifen; unopposed estrogen on uterus (estrogen agonist)
Drug with decreases the risk of endometrial hyperplasia? Why? What is its SE?
Raloxifene; estrogen antagonist in breast and the uterus ; but risk of thromboembolic events
Medication for Mastitis?
Dicloxacillin or cephalexin (strong activity against Stap aureus)
Continue to Breastfeed to avoid abcess development
If MRSA- use TMP-SMX (Bactrum) but risk of kernicterus in newborn
Galctorrhea, headaches, MRI mass in the sella turcica suggests ? What will be the hormonal levels for Dopamine? LH? & FSH?
Pituitary lactotroph adenoma; dopamine is high because prolactin stimulates it, LH & FSH will be low due to negative feed back by inhibition of GnRH secretion
28YO F, with multiple right inframammary lumps, foul-smelling odor, painful welling sin her axillae, erythematous nodules and fistula discharging pus is? Risk factors?
Hidradenitis Suppurativa (HS) or acne inversa- risk: smoking, obesity, hyperandrogenism, impaired glucose tolerance, IBD
6YO F, AA, with 95% height, 99% weight and BMI, coarse hair under both axilla and sparse dark hair on the mons pubis and along the labia majora, no palpable glandular breast tissue? Cause? Risk?
Isolated premature adrenarche or peripheral precocious puberty (PPP). Due to High levels of insulin: Risk: obese pt, AA
42yof with Irregular menstrual periods, nipole discharge, on atypical antipsychotics. Cause of symptoms?
Medication Risperidone, D2 antagonist, no inhibition of prolactin, then prolactin inhibiting GnRH
34F, increased breast tenderness, N, wt gain, urinary frequency for 2 month. Trying to get pregnant for 6 month, B-hCG is neg. Vaginal ultrasonography no abnormalities.
pseudocyesis
