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Paige: Repro > Breast Disorders > Flashcards

Breast Disorders Flashcards

1
Q

what are the 3 most common breast complaints?

A

pain (mastalgia), mass, discharge

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2
Q

can any of those complaints be from something benign?

A

yes and usually are!

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3
Q

is breast pain indicative of breast cancer?

A

RARELY

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4
Q

what usually causes breast pain?

A

hormonal changes

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5
Q

is breast pain more common in pre-menopausal or post-menopausal women?

A

pre

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6
Q

what is cyclic breast pain?

A

breast soreness and heaviness felt 1 week before menses

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7
Q

where is cyclic breast pain most severely felt?

A

upper outer quad

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8
Q

in what age group does non-cyclic breast pain occur?

A

40-50 MC

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9
Q

what does non-cyclic breast pain feel like?

A

sharp or burning, unilateral

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10
Q

is non-cyclic breast pain dangerous?

A

more alarming than the others, but can just be from something benign like having large breasts

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11
Q

how do you treat breast pain?

A

it’s self-limited. bras, analgesics, evening primrose oil

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12
Q

which mastalgia drug can cause androgenic s/e?

A

danazol

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13
Q

can you perform surgery for breast pain?

A

never

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14
Q

what are the 3 types of nipple discharge?

A
  1. normal/lactation
  2. galactorrhea
  3. pathologic
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15
Q

what gets secreted from the nipple during lactation?

A

milk and colostrum

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16
Q

a woman presents to you in family care. She stopped breast feeding 4 months ago, but is still getting a lot of discharge from her nipples and she is worried. What should you do?

A

Tell her that it is normal to have nipple discharge for up to 6 months after breastfeeding

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17
Q

what is galactorrhea

A

bilateral milky discharge involving multiple ducts caused by an increase in prolactin

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18
Q

what is secreted in pathologic nipple discharge?

A

something other than milk

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19
Q

what is the MC cause of pathologic nipple discharge?

A

papilloma

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20
Q

which of the following is pathologic? nipple discharge with compression or spontaneous discharge

A

spontaneous

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21
Q

which of the following is pathologic? nipple discharge that is bilateral or unilateral

A

unilateral

22
Q

which of the following is pathologic? nipple discharge coming from multiple ducts or one duct?

A

one duct

23
Q

which of the following is pathologic? nipple discharge in a woman over 40y or in her reproductive years?

A

reproductive years

24
Q

is bloody discharge pathologic?

A

yes

25
Q

is clear, yellow, white, and/or dark green discharge pathologic?

A

none

26
Q

if nipple discharge is associated with a mass, is it pathologic?

A

yes

27
Q

After a hx and breast exam, what 4 lab values should you get in a patient with nipple discharge

A

hCG, prolactin, TSH, renal

28
Q

when do you refer someone with nipple discharge to surgery?

A

if it is spontaneous + unilateral

29
Q

when a woman is concerned about a breast mass, what history questions should you ask?

A

change in breast, change in skin, nipple inversion or discharge, breast pain and its relationship to cycle, onset and evolution, location, family hx, PMH of breast cancer

30
Q

what are the 5 types of benign breast masses?

A
  1. fibroadenoma
  2. cyst
  3. fibrocystic changes
  4. galactocele
  5. fat necrosis
31
Q

which type of benign breast mass is associated with cyclic breast pain during pre-menopausal years, and is diffuse, tender, and not well defined?

A

fibrocystic changes

32
Q

which type of benign breast mass is a solid, firm, mobile spot that can be “rolled to an edge,” occurs in young women, and is associated with hormones?

A

fibroadenoma

33
Q

which type of benign breast mass is related to milk retention in breastfeeding women?

A

galactocele

34
Q

which type of benign breast mass is a fluid-filled, compressible, ballotable spot that may be painful, and occurs at pre- and peri-menopause?

A

cysts

35
Q

which type of benign breast mass occurs post-trauma, surgery, radiation, or breast augmentation and is hard to distinguish?

A

fat necrosis

36
Q

what is the “triple test” needed for diagnosis?

A

PE

mammography

needle bx

37
Q

what are the 2 types of needle bx?

A

fine needle aspiration

core needly bx

38
Q

how do you manage benign breast masses?

A

follow-up in 2-4mos for breast exam

39
Q

when do you consider a surgical referral for a benign breast mass?

A

if aspirate is bloody

if there is not a complete collapse

if it recurs a lot

40
Q

what 4 other things can cause breast masses?

A

abcess

mastitis

cancer

inflammatory breast cancer

41
Q

what are the sx of lactational mastitis?

A

local, painful breast inflammation

fever, malaise

abcess if left untreated

42
Q

what will you see on PE with lactational mastitis?

A

hard, red, tender, swollen area

43
Q

what organism causes lactational mastitis?

A

S aureus

44
Q

how do you treat lactational mastitis?

A

dicloxacillin or clinda (MRSA)

45
Q

what is gynecomastia

A

benign proliferation of glandular breast tissue in males

46
Q

what do you feel on PE with gynecomastia?

A

palpable mass most likely under the nipple

47
Q

what causes physiologic gynecomastia?

A

hormone imbalance (high estrogen, low androgen)

48
Q

who gets physiologic gynecomastia?

A
  1. neonates
  2. puberty
  3. older males
49
Q

how do you treat physiologic gynecomastia?

A

you don’t, it’s self-limited

50
Q

what causes pathologic gynecomastia?

A

drugs

cirrhosis

hypogonadism

CKD tumors

51
Q

when do you give a mammogram for gynecomastia?

A

unilateral, non-tender, and fixed

52
Q

is male breast cancer common?

A

no super rare

Paige: Repro (9 decks)

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