Breast Flashcards
Breast is formed from
Ectoderm milk streak forms
What hormone is responsible for forming a Double layer of columnar cells -> makes up the duct
Estrogen is responsible for form which component of the breast
What hormone is responsible for lobular development
Progesterone is responsible for forming which component of the breast
What hormone synergizes estrogen and progesterone
Prolactin: synergizes what hormones
Increases in what hormone cause breast swelling and growth of glandular tissue
Estrogen: increases causes what physiolgic effect on the breast
Increases in what hormone causes glandular maturation while withdrawl causes menses
Progesterone increases causes … while with drawl leads to
What hormones causes ovum release
FSH and LH surge causes what
Serratus anterior (winged scapule defect) caused by injury to what nerve
Long thoracic nerve innervates what muscles and injury to it leads to what defect
Latissumus dorsi is inervated by what nerve and injury to said nerve leads to what defect
Thoracodorsal nerve innervates …, injury leads to weak arm movements/adduction/pull ups
Pectoralis Major and Minor are innervated by this nerve where as pectoralis major is only innervated by
medial pectoral nerve innervates» while the lateral pectoral nerve is responsible for
Most commonly injured nerve with MRM and ALND is … and is responsible for…
intercostobrachial nerve responsible for sensation to medial arm and axilla is injured during these 2 surgeries
Blood supply to the breast comes from
internal thoracic artery, intercostal arteries, throcoacromial artery and lateral thoracic artery supply what structure
This valveless vein plexus is responsible for direct hematogenous metastasis of breast cancer to spine
Characteristics and issues with Batsons plexus
Lymphatic drainage of breast 97% goes to..where as 2% goes to..
Axillary nodes account for what percentage of breast drainage compared to internal mammary nodes
What is the primary axillary adenopathy
lymphoma is considered when you have this on …exam
IF found, Supra clavicular nodes do what to your staging
N3 disease is automatic if you find nodes in this locationn
Most common cause of breast abscess is (staph)…where as the organism and risk factors include
Found in lactating mothers, slit nipple and pt that smoke
Treatment of a breast abscess is, while abscesses >3cm have a high propensity to fail this management. while failure i management at this length of time should make you concerned for necrotic breast cancer
percutaneous drainage is treatment of choice for this…If it fails to resolve in 2 weeks will need excisional biopsy including skin to rule out
Infectious mastitis is most commonly associated with … and is causes by staph auresu s
Breast feeding
Galactocele is..and treated by…
breast cyst filled with milk, treated with aspiration vs I&D
Galactorrhea is caused by an increase in this hormone or these drugs
prolactin, OCP, TCA, phenothiazines, metoclopramide, alpha methyl dopa* can cause this in women (or men)
Gynecomastia is associated with
spironlactone, marijuna can cause this condition that most often regresses
Neonatal breast enlargments is caused by…and most often results in
pathology caused by circulating maternal estrogen and most often regresses
Mastodynia is … and treated with
pain in the breast, benign most often in setting normal breast exam and imaging. treatment is with danazol, ocps, nsaids, can be cyclical
Mondors Disease is… treated with nsaids
Superficial venous thrombophlebitis of breast (most commonly associated with trauma), cordlike can be painful treatment is…
Types of Fibrocystic Disease
Fibromatosis, sclerosing adenosis, apocrine metaplasia, duct adenosis, epithelial hyperplasia, ductal hyperplasi
Symptoms of Fibrocystic disease
breast pain, nipple discharge (brown / yellow), lumpy breast tissue that changes with hormonal cycle
most common cause and treatment of bloody nipple discharge
intradutal papilloma usually close to the nipple, work up with ductogramm needle localization followed by subareolar exicsion
spiculated mass with central sclerosis surrounded by entrappted normal ducts and lobules peripherally
Radial scar
Abundant proliferation of stromal epithelial contents
Fibroadenoma
Fat disruption, lipid laden macrophages, chronic inflammation
Fat Necrosis
increased central cellularity with lobules and intact myopithelial contents
sclerosing adenosis
complex, branching fronds, lined with epithelial cells that are cuboidal or columnar
intraductal papilloma
Fibroadenomas are surgical treated at what size and most often present with what symptoms
> 3cm , painless, slow growing , well circumscribed. Popcorn lesions on mammography
Indication for observation of breast mass
Pt is less then 40, mass is clinically benign on exam, imaging consistent with fibroadenoma and FNA/Core needle are concordiant
Serous breast discharge concerning for
malignancy vs green/yellow, brown discharge (consistent with benign disease.
Histological evidence of DCIS
Malignant, cells of ductal epithelium without invasion of basement of membrane - comedo pattern most aggressive subtype - cluster of calcifications on mammography
Treatment of non high grade DCIS
Lumpectomy and XRT (need 2mm margins) Do not need SLNB, possible tamoxifen, raloxifen
Treatment of high grade DCIS
(comedo type, multicentric and multifocal ) if a large tumor not amenable to lumpectomy or if not able to good margins, simple mastectomy also need SLNBx.
