Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Gen Med: Surgery > Breast Disorders > Flashcards

Breast Disorders Flashcards

1
Q

What is included in the breast anatomy?

A

Adipose tissue, glandular tissue, lactation ducts & suspensory ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What info is included in breast hx?

A
  1. Change in general appearance of breast (size, symmetry)
  2. New or persistent skin changes
  3. New nipple inversion
  4. Breast pain (cyclic vs. noncyclic, duration, location)
  5. Breast mass (how it was discovered, duration, change in size, location)
  6. Relationship of mass to menstrual cycles
  7. Nipple discharge (unilateral vs. bilateral, color)
  8. Medications (hormones)
  9. Risk factors for breast cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the risk factors for breast cancer?

A
  1. BRCA1 & BRCA2 gene mutation
  2. first degreerelative w/ breast or ovarian CA
  3. Personal hx of breast dz
  4. age over 70
  5. age at menarche
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the protective factors for breast cancer?

A
  1. Breastfeeding
  2. Parity
  3. Recreational exercise
  4. Postmenopausal BMI less than 23
  5. Oophorectomy at less than 35 yrs
  6. ASA use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is included in the inspection portion of the breast exam?

A
  1. Inspect (arms raised, hands on hips)
    A. Breast symmetry
    B. Skin changes (dimpling, edema, ulceration)
    C. Nipples (symmetry, inversion/retraction, discharge)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is included in the palpation portion of the breast exam?

A
  1. breasts, axillae, entire chest wall
    A. Pain
    B. Masses
    C. Regional lymph nodes (Axillary & Supraclavicular)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is included in the documentation portion of the breast exam?

A
  1. “Clock” system
  2. Location of concern & abnormality
  3. Distance from areola
  4. Size of mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What may be found on exam?

A
  1. Lump, hard knot, or thickening muscle inside the breast or underarm
  2. Dimpling or puckering of the skin
  3. Nipple discharge that starts suddenly
  4. Swelling, warmth, redness or darkening of the breast
  5. Itchy, scaly sore or rash on the nipple
  6. Change in the size or shape of the breast
  7. Pulling in of the nipple or other parts of the breast
  8. New pain in one spot that does not go away
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the “more in depth” characteristics of a benign tumor?

A
  1. Morphology/differentiation: well differentiated appearance, structure similar to tissue origin, little or no anaplasia
  2. Rate/pattern of growth: SLow, progressive expansion, rare mitotic figures, normal appearing mitotic figures
  3. Local invasion: no invasion, cohesive and expansive growth, capsule often present
  4. Metastasis: no metastasis
  5. Damage to human body: relatively smaller
  6. Prognosis: Good
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the “more in depth” characteristics of a malignant tumor?

A
  1. Morphology/differentiation: lack of differentiated appearance, structure atypical, variable degree of anaplasia
  2. Rate/pattern of growth: SLow to rapid expansion, mitotic figures numerous, sometimes abnormal appearing mitotic figures
  3. Local invasion: local invasion, infiltrative growth, capsule not present
  4. Metastasis: frequent metastasis
  5. Damage to human body: relatively bigger
  6. Prognosis: poor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the characteristics of benign breast masses?

A
  1. Multiple lesions
  2. “Rubbery”
  3. Mobile
  4. Well circumscribed border
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of malignant breast masses?

A
  1. Single lesion
  2. Hard
  3. Immovable
  4. Irregular borders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the characteristics of benign nipple discharge?

A
  1. Bilateral
  2. Multiductal
  3. Milky
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the characteristics of malignant nipple discharge?

A
  1. Unilateral
  2. Uniductal
  3. Bloody, Clear, or Colored
  4. Spontaneous
  5. Persistent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the characteristics of benign skin changes?

A
  1. None

2. *Induration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the characteristics of malignant skin changes?

A
  1. Retraction
  2. Dimpling
  3. Thickening
  4. Eczema appearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the nonproliferative benign breast dz?

A
  1. Fibrocystic changes
  2. Simple cysts
  3. Lactational adenoma
  4. Fibroadenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the benign hyperplasia w/out atypica dz?

A
  1. Epithelial hyperplasia
  2. Sclerosing adenosis
  3. Intraductal papillomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the hyperplasia w/ atypica dz?

A

DCIS
LCIS
May become malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the malignant types of breast cancer?

A
  1. Ductal CA
  2. Lobular CA
  3. Tubular CA
  4. Mucinous CA
  5. Micropapillary CA
  6. Metaplastic CA
  7. Inflammatory CA
  8. Paget’s Dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the ddx for mastalgia?

A 
1. Cyclic
A. Cyclic mastalgia
B. Fibrocystic disease
2. Non-cyclic
A. Large pendulous breasts
B. Diet, lifestyle
C. Mastitis
D. HRT
E. Inflammatory breast CA
3. Extramammary (non-breast) pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What hx needs to be obtained regarding mastalgia?

A
  1. Unilateral vs. bilateral
  2. Cyclic vs. noncyclic
  3. Systemic or local symptoms (e.g. erythema, fever)
  4. History of trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What imaging needs to be obtained regarding mastalgia?

A
  1. Ultrasound

2. Mammogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is cyclic mastalgia?

A
  1. Normal hormonal changes

2. Usually luteal phase of menstrual cycle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is fibrocystic dz?
Increased fibrous or cystic tissue
26
What causes pendulous breasts?
Stretching of Cooper’s ligaments
27
Who is at risk for fibrocystic dz?
Premenopausal women
28
What is included in fibrocystic dz?
1. Premenstrual breast swelling/tenderness | 2. Nodules/masses/lumps related to dense breast tissue or cysts
29
How is fibrocystic dz managed?
``` 1. Lifestyle A. Eliminate caffeine B. Low fat diet 2. Symptomatic A. Support garments (well-fitting, supportive bra, sports bra) B. Compresses 3. NSAID’s A. OCP’s (Progestogens) B. Rarely: -Danazol -Tamoxifen - IF severe mastalgia ```
30
What is the presentation for mastitis?
1. Usually seen in breastfeeding mothers 2. Unilateral, swollen, wedge-shaped area of breast 3. Pain, redness, induration (hardening) 4. Systemic symptoms (high fever, malaise, chills)
31
What is the treatment for mastitis?
1. Rest, fluids, MH 2. Dicloxicllin 500mg QID x 10-14d 3. Continue frequent breast feeding
32
What is inflammatory breast cancer?
1. Peau d’orange-dimpling of involved skin due to retraction caused by lymphatic involvement & obstruction 2. Associated erythema, pain 3. Cellulitis may mimic inflammatory CA
33
How does Paget's dz present?
1. Presents as skin changes resembling eczema | 2. Redness, discoloration, or mild flaking nipple skin
34
How does advanced paget's dz present?
1. Tingling, itching, ↑ sensitivity, burning, & pain 2. +/- nipple discharge 3. ≈ 50% also have a breast lump
35
True/false: More than 90% of palpable breast masses in women in their 20’s to early 50’s are benign. What are the ddx?
True 1. Fibrocystic changes 2. Fibroadenoma 3. Fat necrosis 4. Phyllodes tumor 5. Intraductal papilloma 6. Breast cancer
36
What is included in the hx of a breast mass?
1. How it was discovered 2. Duration 3. Change in size 4. Location 5. Relationship of mass to menstrual cycles
37
What is a fibroadenoma?
1. Solitary, firm, rubbery, mobile mass A. Firm, tan, lobulated B. Well circumscribed mass C. Variable size 2. Women less than 30 3. Slow growing
38
What is phyllodes tumor?
1. Resembles fibroadenoma | 2. Formed w/in the stroma (connective tissue)of the breast
39
How is phylodes tumor staged?
1. Phyllodes tumors are not staged usual sense A. Classified on the basis of cytology B. Benign, borderline, or malignant
40
What is Intraductal papilloma?
1. Unilateral bloody nipple discharge 2. Sub-areolar intraductal mass 3. Benign tumor
41
What is fat necrosis?
1. Caused by trauma | 2. Tender, firm mass w/ indistinct borders
42
How is fat necrosis sen on exam?
1. May appear suspicious on exam | 2. Benign breast calcification seen on mammo
43
How is fat necrosis evaluated based on age?
1. 30 yr – Diagnostic mammogram
44
How is fat necrosis evaluated based on composition?
1. Simple cyst A. Symptomatic – Aspirate B. Asymptomatic – Observe for 2-4 months 2. Complex cyst – A. USN-guided needle aspiration/Bx B. Solid mass – Core needle biopsy (CNB) or Excision 3. No specific findings – Re-examine after two cycles
45
What are the physiologic etiologies of nipple discharge?
1. Lactation 2. Physiologic nipple discharge (Galactorrhea) A. Hyperprolactinemia B. Hypothyroidism C. Medication related D. Neurogenic stimulation
46
What are the pathologic etiologies of nipple discharge?
1. Intraductal papilloma 2. Ductal ectasia 3. DCIS
47
What is included in nipple discharge hx?
1. Unilateral vs. bilateral 2. Spontaneous vs. provoked discharge 3. Appearance of discharge 4. Medications (e.g. antipsychotics, antidepressants) 5. History of trauma 6. History of amenorrhea 7. History of hypogonadism (e.g. hot flashes, vaginal dryness)
48
What is included in the clinical breast exam for nipple discharge?
1. Attempt to elicit discharge, identify involved duct(s) | 2. Evaluate discharge for gross blood or guaiac
49
What is included in the initial evaluation of nipple discharge?
1. Breast USN 2. Mammogram A. If woman > 30 yrs 3. Multiductal discharge A. Prolactin, TSH, urine HCG
50
What is included in the further evaluation of nipple discharge?
1. Ductography 2. Ductoscopy 3. MRI
51
How is physiologic nipple discharge managed?
Directed at underlying cause
52
How is pathologic nipple discharge managed?
1. Surgery A. Terminal duct excision B. Intraductal papilloma C. Cause in > 50% of cases
53
What are the general characteristics of breast cancer?
1. Poorly differentiated lump or found on mammo/USN 2. > 80% of breast CA cases discovered by pt 3. Genetics believed to be cause of 5–10% of cases 4. Atypical ductal hyperplasia (DCIS & LCIS) found in fibrocystic breasts → ↑ risk 5. DM may ↑ the risk
54
What are the life style risk factors for breast cancer?
1. Long-term smokers ↑ 35% to 50% | 2. Sedentary lifestyle ↑10%
55
What are the common sites of metastasis from breast cancer?
1. Bone 2. Liver 3. Lung 4. Brain
56
Define malignant breast disease?
1. Pathologic finding on FNA, core needle Bx or excision Bx A. DCIS/LCIS B. Invasive carcinoma
57
What are the treatment modalities for malignant breast dz?
1. Radiation 2. Chemotherapy 3. Lumpectomy 4. Mastectomy 5 .Hormonal therapy
58
What is included in breast cancer screening?
1. Self Breast Exam monthly 2. Clinical Breast Exam every 2-3 yr age 20-40; annually > 40 3. Mammogram Baseline age 35-40; Q 1-2 yr 40-50; Annually > 50 4. BRCA1, BRCA2- strong FH or gene present (Only obtain if it changes your Tx plan)
59
What are the general characteristics of breast CA?
1. 12% lifetime risk 2. 50% develop in upper outer quadrant (most common site) 3. Invasive ductal carcinoma is most common (90%) 4. Staging TMN- tumor/mets/nodes (stages I-IV) 5. Often found through screening, asymptomatic early
60
What is Stage 0 breast cancer?
1. pre-cancerous or marker condition | 2. DCIS or LCIS
61
What is Stage 1-3 breast cancer?
w/in the breast or regional lymph nodes
62
What is Stage 4 breast cancer?
metastatic cancer that has a less favorable prognosis
63
How is breast cancer diagnosed?
1. Screening measures first- mammogram or ultrasound 2. FNA, core biopsy, open biopsy 3. Hormone receptors must be checked (Estrogen & Progesterone)
64
What is included in the pre-op workup for breast cancer?
1. Bilateral mammogram/MRI/US- Cancer in one breast is a risk factor for CA in contralateral breast 2. R/O metastasis A. CXR B. CBC C. LFT’s D. CA+ E. Alk Phos F. Maybe brain CT
65
How is the breast divided?
4 quadrants + Tail of Spence
66
What are the nerves in the breast that you need to be aware of in masectomies?
1. Long Thoracic - Lateral chest midaxillary line-> Serratus anterior muscle 2. Thoracodorsal - Lateral to long thoracic-> Lat dorsi 3. Medial pectoral- Through pec minor-> Pec minor/major 4. Lateral pectoral- Medial to medial pectoral-> Pec major
67
What are the boundaries of axillary dissection?
1. Superior boundary-> Axillary vein 2. Posterior boundary->Long thoracic nerve 3. Lateral boundary-> Lat dorsi 4. Medial boundary-> Pec minor muscle
68
What are the types of breast surgery?
1. Mastectomy: Removal of the whole breast 2. Quadrantectomy: Removal of ¼ of breast 3. Lumpectomy: Removal of a small part of breast
69
What is included in lumpectomy and radiation?
1. Removal of part of breast w/ axillary node dissection | 2. For stage I & II (tumors
70
What is included in modified radical mastectomy?
1. Breast, axillary nodes & nipple are removed | 2. Drains left in place to drain fluid
71
How is inflammatory CA managed?
always treat w/ Chemo first!
72
What is Adjuvant therapy for breast CA?
1. hormone blocking therapy 2. Chemotherapy 3. Monoclonal antibodies 4. Radiotherapy
73
What is hormone blocking therapy?
1. If estrogen receptors (ER+) &/or progesterone receptors (PR+) A. Tamoxifen –blocks estrogen receptors B. Aromatase inhibitor – block estrogen production -Post-menopausal only (Aromasin, Femara, Arimidex)
74
When is chemotherapy indicated for breast cancer?
Stages 2-4
75
What is se of monoclonal antibody therapy?
HER2+ tx w/ trastuzumab(Herceptin) – risk of heart damage
76
How does monoclonal antibody therapy work?
HER2 causes cellular growth & division)
77
What is radiotherapy?
1. External beam radioTx | 2. Brachytherapy (internal w/surgery)
78
What is included in the post-op after a mastectomy?
1. Usually home same day or 1-2 days post- op depending on extent of case 2. Careful monitoring of drain output-> d/c when
79
What complications may arise from mastectomy?
1. Long thoracic nerve injury “winged scapula” deformity 2. Arm lymphedema 3. Hematoma/seroma 4. Skin flap necrosis

Gen Med: Surgery (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions