Breast Conditions- Onello

Question 1

Polythelia:

Answer 1

multiple nipples

Question 2

polymastia:

Answer 2

multiple regions of breast tissue (extra breast in axilla region)

Question 3

Athelia:

Answer 3

lack of nipples

Question 4

Amastia:

Answer 4

absence of breast, nipple, and possibly the pectoralis mm

Question 5

Tanner staging of breast:

Answer 5

Stage 1: preadolescent nipple elevated with no underlying tissue or pigmentation
Stage 2: glandular tissue in subareaola is obvious. Nipple and breast are single mound
Stage 3: increase in palpable glandular tissue with increased diameter and pigmentation of areola, breast and nipple in single plane
Stage 4: areola further enlarges. Mound on mound
Stage 5: smooth contour with projection of nipple and areola

Question 6

Tanner staging female pubes:

Answer 6

1: no pubic hair
2. straight hair along and between labia
3. increased quantity, darker, and typical female triangle
4. more dense and curly.
5. includes medial aspect of thigh. adult pattern of pubic hair

Question 7

Tanner staging male:

Answer 7

1. prepubertal- no pubes, genitalia unchanged from early childhood
2. light colored hair develops laterally and penis and testes may become slightly larger.
3. pubic hair extends across top of penis, testes and scrotum further enlarge
4. more curling of pubic hair. glans has become larger and broader
5. quantity and pattern of pubes is adult in style. goes down on medial aspect of thigh

Question 8

What is most typical reason for gynecomastia in boys?

Answer 8

normal development

Question 9

Breastfeeding recommendation by American Academy of Pediatrics?

Answer 9

Exclusive breastfeeding for ~6mo

Combo breastfeeding with introduction of new foods until at least 12mo age

Question 10

WHO breastfeeding recommendations?

Answer 10

Exclusive breastfeeding for ~6mo age

Continued breastfeeding along with complementary food introduction up to 2y or beyond

Question 11

Hx questions for breast concerns?

Answer 11

Duration
change over time
relationship to menses
nipple discharge
presence of pain
family hx
gyne-endocrine hx
previous cyst aspirations
personal risk of atypical breast hyperplasia

Question 12

Clinical breast exam:

Answer 12

inspect seated and supine
evaluate for nipple discharge
examine supraclavicular and axillary lymph areas
ideal is 1wk post menses

Question 13

what are reassuring mass types?

Answer 13

smooth, mobile, well-demarcated

Question 14

BI:RADS categories (breast imaging reporting and data system?)

Answer 14

Category 1- incomplete
category 1- negative--routine f/u
2- benign finding- routine f/u
3- probably benign- short intervall f/u
4- suspicious --biopsy
5- highly suggestive--biopsy
6- known malignancy--follow progress

Question 15

USPTF breast cancer screening recommendations:

Answer 15

50-74yo: biennial
40-49yo: individual decision
75-older yo: insufficient evidence

Question 16

Fibroadenoma characteristics? tx?

Answer 16

Characteristics: proliferating epithelium and supporting fibrous tissue, hyperplasic process of a single duct
benign
smooth, mobile, round
may be affected by menses
tx: monitor for 1-3mo

Question 17

Cystosarcoma phylloides:

Answer 17

cellular stroma with nuclear aatypia and mitotic figures
painless
tx: excise with wide margins