Breast Flashcards
A 65-year-old white woman presents to her doctor for a routine screening mammogram, which demonstrates a cluster of pleomorphic micro-calcifications that are located in the upper outer quadrant of her left breast. One year ago, her mammogram showed no abnormalities; the patient has been diligent in undergoing annual mammograms because her mother was diagnosed with breast cancer at the age of 50 years.
Primary invasive breast cancer
A 68-year-old white woman presents to her doctor with a 3-month history of a painless lump in the upper outer quadrant of her breast. During his clinical examination, her doctor notes that, in addition to the hard 2-cm mass that is located in the upper outer quadrant of her breast, the patient also has 3 enlarged ipsilateral axillary lymph nodes.
Primary invasive breast cancer
A 58-year-old white woman has clustered microcalcifications in the right breast on routine mammography, which were not seen on her previous mammogram. She is post-menopausal, has used hormone replacement therapy for 6 years, and has a BMI of 26.
Breast cancer in situ
A 55-year-old post-menopausal black woman presents with 2 new areas of breast nodularity that do not resolve. Mammography is negative.
Breast cancer in situ
A 60-year-old woman presents after feeling a lump in her right breast. Mammogram confirms a lesion in the area of the palpable mass. The patient is referred to a surgeon, who performs a physical examination, which is otherwise negative. Core biopsy of the lesion demonstrates ductal carcinoma. Excisional biopsy and axillary evaluation are performed, with one lymph node containing invasive duct carcinoma. CT scan of the chest and abdomen and bone scan are performed. Two lesions are identified in the lung, consistent with metastases.
Metastatic breast cancer
A 52-year-old woman presents with an abnormal left mammogram. Stereotactic biopsy demonstrates invasive ductal carcinoma. Excision of the cancer leaves negative margins, and lymph node evaluation does not demonstrate disease spread to the axilla. Three years later, the patient presents complaining of pain in her lower left rib and denies trauma. Bone scan demonstrates multiple rib lesions, consistent with disease spread to the rib. The remainder of the metastatic work-up is negative. FBC and liver panel are normal except for alkaline phosphatase, which is elevated.
Metastatic breast cancer
A 28-year-old woman in her second post-partum week presents with recent-onset breast pain and a tender wedge-shaped area in one breast that feels firm, warm, and swollen, and appears erythematous. She has decreased milk output, flu-like symptoms, pyrexia of 38°C (100.4°F), and myalgia, in addition to feeling fatigued.
Mastitis
A 30-year-old woman who has recently had breast surgery presents with sharp shooting breast pain and an exquisitely tender, swollen, red, and warm fluctuant peri-areolar breast mass.
Breast abscess
A 55-year-old nulliparous woman presents with a two month history of green discharge and pain in her right nipple. On examination, her nipple is inverted, and a small mass can be felt.
Benign duct ectasia (benign)
A 48-year-old nulliparous woman presents with a one month history of bloody nipple discharge and pain in her left breast and nipple.
Intraductal papilloma (benign)
A 54-year-old woman presents with a three day history of a large painful lump in her breast. She notes that she has had a similar thing once or twice before over the past two months. She is also on HRT therapy. On examination, the lump is hard and mobile.
Breast cyst
A 31-year-old woman presents with a two day history of pain in her right breast and bloody discharge from the nipple. On examination, the nipple appears red and inflammed and you note the woman has a nipple ring.
Periductal mastitis
A 25-year-old nulliparous woman presents after noticing a ‘ painless lump in her left breast’ two days ago. On examination, the lump feels firm and very mobile, with a smooth surface.
Fibroadenoma
