Breast Disorders Flashcards
How does folliculitis present?
Painful nodule with shaving of axillary hair
How does Paget’s disease of breast appear?
Confined to nipple and areola:
Severe itching (like eczema)
Redness, ulceration, scaling and flaking of nipple
Areola with clear yellow exudate
What workup if Paget’s disease of breast is suspected?
Punch biopsy for diagnosis, followed by diagnostic mammography due to underlying malignancy in 85% of cases
When are accurate prolactin levels obtained?
While fasting, after 24h without breast stimulation
What may be indicated by cyclic mastalgia during reproductive years?
Fibrocystic breast changes
What obligates an excisional biopsy of a breast mass?
Bloody fluid
What is the next action for a non-diagnostic aspiration of breast mass?
Excisional biopsy
What are main uses for breast ultrasound?
Tissue very dense on mammogram (those age <30)
Help distinguish between cyst and solid initially, especially in women age <30 presenting with new breast mass
Breast MRI, in addition to mammogram, is indicated for which high risk patients?
BRCA and 1st-degree relatives of BRCA carriers
Li-Fraumeni and other mutations
>20% risk based on risk prediction modeling
Hx of radiation to chest between 10-30 yo
Subareolar breast mass and nipple discharge suggest what?
Mammary duct ectasia
What is a phyllodes tumor?
Rare breast tumor similar to fibroadenoma at first but later grows much larger, with resultant changes to shape, contour, and skin (e.g. necrosis) of breast
When is MRI indicated with respect to breast cancer?
Searching for metastases
Screening in high-risk patients
How would Candida of breast present?
Deep, sharp breast pain out of proportion
Pruritis, erythema
Candida intertrigo has red-brown lesions within skinfold
What is most common cause of unilateral bloody nipple discharge without coexisting mass or LAD?
Intraductal papilloma - originate from breast duct lining and typically nonpalpable
