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OBGYN rotation review > breast disorders > Flashcards

breast disorders Flashcards

1
Q

where it the primary lymphatic area that breast cancer spreads to

A

axillary lymph nodes

also

internal mammary nodes

supraclavicular nodes (late)

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2
Q

fibrocystic changes cause ___lateral, ____, ____ breast pain

A

fibrocystic changes cause BIlateral, diffuse, cyclic breast pain

(during the luteal phase)

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3
Q

what are some pathologic causes of nipple discharge

A

intraductal papilloma

ductal ectasia (usually has pain)

carcinoma

infection

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4
Q

benign breast masses have ___ margines

whereas

malignant breast masses have ___ margins

A

benign breast masses have well-defined margines

whereas

malignant breast masses have poorly-defined margins

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5
Q

brachytherapy radiation

A

days

(less time than external beam radiation)

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6
Q

which noninvasive breast carcinoma does NOT become invasive if left untreated

A

lobular carcinoma in situ (LCIS)

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7
Q

benign/malignant:

hard, immobile, fixed

A

malignant

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8
Q

what do you need to do before you do an MRI

A

check baseline BUN and creatinine

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9
Q

cluster pleomorphic calcifications on mammogram

A

ductal carcinoma in situ (DCIS)

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10
Q

almost all of PTs w/ this type of breast CA have lymph node involvement

1/3 have distant mets

A

Inflammatory Breast Cancer (IBC)

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11
Q

what dye is used for MRI

A

IV gadolinium

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12
Q

very rare but aggressive breast CA

A

inflammatory breast cancer

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13
Q

what is the treatment for ductal carcinoma in situ (DCIS)

A

Breast Conserving Surgery (BCT) with radatian

or

mastectomy

+/- sentinel lymph node biopsy

+/- tamoxifen/arimidex (if estrogen/progesterone positive)

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14
Q

what are the views for a diagnostic mammogram

A

2 craniocaudal (CC)

+

2 mediolateral oblique (MLO)

+ more views

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15
Q

which diagnostic test is used to obtain samples from a larger, solid breast mass

A

Core-Needle Biopsy

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16
Q

why would you do an MRI

A

detect brast CA in high risk women

to stage breast cancer

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17
Q

benign/ malignant:

smooth, soft to firm, mobile breast masses

A

benign

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18
Q

which noninvasive breast carcinoma is treated as a malignancy b/c of it’s potential to develop into an invasive CA

A

ductal carcinoma in situ (DCIS)

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19
Q

when during the menstrual cycle is the best time to perform a breast exam

A

follicular

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20
Q

what drugs are used for chemoprevention

A

tamoxifen

arimidex

raloxifene

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21
Q

what are the views for a screening mammogram

A

2 craniocaudal (CC)

+

2 mediolateral oblique (MLO)

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22
Q

rapidly progressing pain

tender, firm, enlarged breast

warm, thickened skin

peau d’orange

erythema

A

inflammatory breast CA

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23
Q

why would you do a Fine Needle Aspiration

A

initial method for evaluating a mass with a LOW pretest probability of CA

to determine if a palpable lump is a simple cyst

24
Q

benign/malignant:

skin changes

A

malignant

25
Q

1st: breast pain/ burning/ puritis

then

scaly/ raw/ vesicular/ ulcerated lesion that begins on the nipple and spreads out to the areola

+/- bloody discharge

usually unilateral

A

paget disease of the breast

(PBD)

26
Q

medications can cause ___lateral, ____, ___ breast pain

A

medications can cause UNIlateral, focal, NON-cyclic breast pain

27
Q

which diagnostic test is the initial method for evaluating a mass with a low pretest probability of CA

A

Fine Needle Aspiration

28
Q

chemoprevention (tamoxifen, arimidex, raloxifene) is recommended for which asymptomatic women

A

over 35 w/out prior hx of breast CA

BUT

are at increased risk

29
Q

with hematogenous spread, where does breast cancer spread to most frequenty

A

lungs and liver

also

bone, ovaries, brain

30
Q

radical mastectomy

A

entire breast, lymph nodes, pectoralis muscle

(rarely performed)

31
Q

what are GI meds that cause nipple discharge

A

cimetidine

metoclopramide (reglan)

32
Q

what are some physiologic causes of nipple discharge

A

meds

neurogenic stimulation

galacotorrhea from prolactinoma

33
Q

what is the most appropriate treatment for stage 1 or 2 breast carcinoma

A

Breast Conserving Surgery (lumpectomy) with post operative radiation

34
Q

which diagnostic test is NOT recommended for the eval of a breast mass

A

MRI

35
Q

what treatment is used in

primary breast CA

metastatic breast CA

and

all patient with (+) lymph nodes

A
36
Q

what are psych meds that cause nipple discharge

A

anti-psychotics

MAOIs

neuroleptics

SSRIs

TCAs

37
Q

what is herceptin

A

drug that targets the HER2/neu protein (which is a growth promoting protein found in 20% of breast CA)

effective in early stage CA and metastic dz

used in combo w/ chemo

38
Q

what areas of the body are radiated when treating breast CA

A

breast

chest wall

regional lymph nodes

axilla

39
Q

what are opiods that cause nipple discharge

A

codeine

heroin

methadone

morphine

40
Q

what is treatment for lobular carcinoma in situ (LCIS)

A

lifelong surveillance

+/- taxmoxifen/arimidex (chemoprevention)

+/- bilateral prophylactic mastectomy

41
Q

neoadjuvant chemo

A

given before surgery to shrink size of tumor

may allow for breast conservation surgery

42
Q

simple mastectomy

A

entire breast + nipple + areola removed

43
Q

what are anti-HTN meds that cause nipple discharge

A

methyldopa

reserpine

verapamil

44
Q

why would you do an US

A

inconclusive MMG results

young women

dense breast tissue

for better differentation b/w solid and cystic mass

to guide tissue core-needle biopsy

45
Q

who should you consider doing genetic screening for BRCA genes?

A

male breast CA

Jewish ancestry + HBOC CA

triple negative breast CA diagnosed before 60

patient/ 1st-3rd degree relative CA before 50

patient/ 1st-3rd degree relative w/ invasive ovarian/ fallopian tube/ primary peritoneal CA

2+ 1st-3rd degree relatives w/ breast/prostate/pancreatic CA

46
Q

adjuvant chemo

A

given after surgery

kills the cancer cells left behind

47
Q

external beam radiation takes

A

5-7 weeks

48
Q

what are hormone meds that cause nipple discharge

A

estrogen

oral contraceptives

49
Q

what is a total mastectomy also called

A

simple mastectomy

50
Q

modified radical mastectomy

A

entire breast + nipple + areola removed

+

axillary lymph nodes

51
Q

what is the most common breast malignancy

A

infiltrating ductal carcinoma

52
Q

the strongest risk factors for breast CA are

(2)

A

female gender

age

53
Q

which BRCA gene has a greater risk for breast CA in men

A

BRCA 2

54
Q

which BRCA gene has a greater risk for breast CA in women

A

BRCA 1

55
Q

which BRCA gene has a greater risk for ovarian CA

A

BRCA 1

OBGYN rotation review (14 decks)

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