Breast Disorders- Paulson Flashcards
A patient comes in with a small brown freckle along the milk line that is cosmetically weird looking and the patient wants to know what it is. What should you tell the patient?
It is a supernumerary nipple and this is completely normal
An enlargement of the breasts that occurs in males is called what?
Gyneocomastia
*Spironolactone or risperodone can cause this
A patient presents with increased swelling, pain and enlarged breasts commonly with OCPs and cyclic with her menstrual cycle. What will you tell her this is?
Mastodynia (breast pain/tenderness)
What is the tx for Mastodynia (breast pain/tenderness)?
Reasurrance
- Vit B6 can help
- Supportive bra
- NSAID
What is the primary organism that causes mastitis?
S. aureus
A lactating women presents with red hot and swollen LUQ breast with flu like symptoms. What should you tell her the condition is called?
Mastitis
What is the tx for mastitis?
Dicloxacillin
A patient presents with a 1 day hx of painful, swollen breast with an induration filled with pus. WHat is this and what is the tx?
Breast abscess
-I&D and Dicloxacillin
Can a patient with mastitis continue to breast feed?
Yes
If a patient with a suspected breast abscess does not get better, what should you do?
If patient does not respond to treatment, suspect inflammatory breast cancer especially if associated with axillary lymphadenopathy
You feel a firm nodule on a patients breast. You suspect fat necrosis of the breast. How do you determine if CA or non-CA?
Biopsy
Is breast cancer usually painful?
No
A patient states that every time around her menstrual cycle she has increased firm oval shaped nodules that develop in her breasts. What is the dx and tx?
Fibrocystic breast changes and a supportive bra
-Avoid caffeine, low salt diet, Vit E
A patient has a round firm, smooth and rubbery mass in her breast. What is this and what are the next steps?
Core needle biopsy or 3-6 month follow up with repeat ultrasound and breast exam
T/F: Nipple discharge is totally normal if a patient is not lactating?
false - always need to be suspicious of nipple d/c if a patient is not lactating
What should you do next for a patient with nipple discharge?
order a u/s or mammogram
Wht are some risk factors for breast cancer?
Nullparity, early menarche, late menarche, late menopause, long term estrogen exposure, child bearing >30 yrs and first degree relatives
_______ puts people at a higher exposure for breast CA
estrogen
A patient states that she thinks she has eczema over her nipple x 1 month. She has tried some creams without improvement. What should we work the patient up for?
This is pagets disease of the breast but it is breast cancer until proven otherwise. the patient will need a full-thickness bx
Lobular carcinoma is a _______ find
Lucky
Lobular=lucky because there is an increased risk of developing breast cancer
What is the most common quadrant for breast cancer?
Upper outer quadrant
P’eau d’orange and retraction of the nipple are serious signs of what?
Invasive carcinoma
What are the current guidelines for mammography?
Every year starting at age 40 as long as a woman is in good health and can switch to every other year at age 55
-Age 50 to 64 every other yr
For high risk women, what imaging is recommended in addition to mammogram every year starting at age 30?
For women at high-risk, recommend MRI in addition to mammogram every year starting at age 30 (ACS)
What is the best way to detect breast cancer?
Combo of PE, mammography, u/s, fine needle or core needle and/or excisional bx
Can men get breast cancer?
Yes, typically develops as a painless lump beneath the areola and generally a poorer prognosis than in women
Are there any health benefits for babies that drink breast milk?
Ye great health benefits and this is where the baby gets all the antibodies from
what is the let down relfex?
By sucking at the breast, your baby triggers tiny nerves in the nipple.These nerves cause hormones to be released into your bloodstream. Prolactin stimulates the mammary glands to produce milk. Oxytocin helps milk to be ejected
