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OBGYN Clerkship > Breast Cancer > Flashcards

Breast Cancer Flashcards

1
Q

What is the blood supply of the breast?

A

internal mammary (off subclavian) and lateral thoracis (off axillary) arteries

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2
Q

What LN drain the breast

A

Axillary&raquo_space;» internal mammary

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3
Q

Effect of __ on breast

  • estrogen
  • progesterone
  • PRL
  • oxytocin
A
  • estrogen = ductal development and fat deposition
  • progesterone = lobar-alveolar (stromal) development
  • PRL = milk production
  • oxytocin = milk let down
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4
Q

Pt comes in with breast pain, next step?

A

h/o trauma = get US
high risk = get mammo
likely benight from H&P = reassurance, NSAIDs, sports bra, compress

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5
Q

Blood discharge, think

A

intraductal papilloma

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6
Q

milky discharge from nipple, think

A

preganacy
hyperPRL
hypothyroid
what meds are they taking (anti-psych)

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7
Q

yellowish discharge from breast, think

A

fibrocystic change
galactocele
acute mastitis

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8
Q

green/stick discharge from nipple, think

A

mammary duct ectasia

wiki: the lactiferous duct becomes blocked or clogged. Mammary duct ectasia can mimic breast cancer. It is a disorder of peri- or post-menopausal age.

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9
Q

purulent nipple discharge, think

A

breast abcess

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10
Q

what is the incidence of breast cancer

A

1 in 8 women

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11
Q

who gets screened for breast cancer

A

> 50 q2year

> 40 q year if strong fam history

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12
Q

What is the MC location of breast cancer?

A

upper outer quadrant

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13
Q

What are the MC site of breast cancer mets?

A

bone, liver, lung, brain, pleura

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14
Q

What is the MC breast mass in
< 25 yo?
24-50?
> 50?

A

< 25 yo = fibroadenoma
24-50 = fibrocystic change
> 50 = infiltrating ductal carcinoma

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15
Q

are malignant masses usually painful or painless?

A

painless

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16
Q

find a breast mass in > 30 yo, next step?

A

mammo + core needle Bx –> excision if non-diagnostic

17
Q

Find breast mass in < 30 yo, next step?

A

US

18
Q

You get an US of a brast mass and it is solid, what is next step?

A

FNA

19
Q

You get an US of a brast mass and it is cystic, what is next step?

A

drain it, if it is bloodyor recurrent, get a core needle bx

**f/u in 4 weeks

20
Q

What is the BI-RADS

A

classification of mammos

21
Q 
what does the BI-RADS score mean?
0
1
2
3
4
5
6
A 
0 = incomplete/needs addnl imaging
1 = negative/routine follow up
2- benight/routine follow up 
3= probably benign/short term follow up (6mo)
4 = suspicious/core needly bx
5 = probmalignant/core needle bx
6 = def malignant/seek treatment
22
Q

firm, mobile mass <5cm, in young woman

A

fibroadenoma

23
Q

a firm moblie mass > 5cm seen in teens with rapid breast growth, Tx?

A

giant juvenile fibroadenoma, tx is excision to avoid breast defomity

24
Q

bloodly nipple discharge + tx

A

intraductal papilloma, tx galactogram/ductogram guided excision (due to small risk of carcinoma)

25
Q

huge benign tumor that distorts breast

A

phyllodes tumor

26
Q

mammo that shows clustered microcalcifications is most liekly

A

DCIS/infiltrating

27
Q

mamo that shows multiple/bilateral tumors is most likely

A

LCIS/infiltrating

28
Q

MC breast cancer

A

infiltrating ductal carcinoma

29
Q

“crusty” nipple eczema

A

paget’s disease

30
Q

Staging for breast cancer

A 
1= < 2cm
2= < 2cm or LN+
3 = 2+ nodes
4= distant mets
31
Q

treatemtn for ER/PR+ breast cancer

A

tamoxifen and aromatise inhibitors (letrozole, anastrazole, exemstane)

32
Q

Her2/neu+ inficates good or poor prognosis

A

poor

33
Q

treatment for Her2/neu+

A

trastuzamab

34
Q

what is a modified radical mastectomy

A

removes breast, pec maj/min and axillary LN

35
Q

painful, multiple, bilateral lumps that vary with menstrual cycle + Tx?

A

fibrocystic change

dec tea/caffine/chocolate, aspirate domainant lump

36
Q

next step if pt has atypical ductal hyperplasia on bx?

A

excision bc has hish risk of becoming cancer

37
Q

treatment for acute mastitis

A

dicloxacillin + CONTINUE Breast feeding

38
Q

b/l breast pain and green/sticky d/c in perimenopausal woman

A

mammary duct ectasia

39
Q

presents as breast lump and calcification following trauma, next step?

A

dystrophic calcification, excision and bx to r/o cancer

OBGYN Clerkship (31 decks)

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