Breast Health Flashcards
What days of the menstrual cycle are ideal for self breast examination
Days 3-10
what are the breast screening recommendations for women ages 20-39
Clinical Breast Exam
what are the breast screening recommendations for women ages >40 (2)
1- Clinical Breast Exam
2- Mammogram
Why is ultrasound used in addition to Mammogram with breast imagery?
Because it allows for assessment of a targeted area
What is the primary diagnostic tool for breast cancer for women greater than 30
Ultrasound
How is MRI utilized in diagnosing breast cancer?
Adjunct to mammo in high risk women
What age is fibroadenoma most common in?
Under age 30
When can a fibroadenoma grow rapidly?
1- during adolescence
2 Pregnancy
3- lactation
How does a fibroadenoma present
Small pea or marble like, painless lump in once breast
Fluid filled lesions in the terminal ducts or lobule
Breast Cyst
What phase are breast cyst most common?
Luteal phase
When do breast cyst typically disappear?
During menopause
What will the patient complain of when they have a breast cyst?
bilateral, full, heavy or aching breast with pain radiating to axilla or arm
What are some medication treatments for Breast cyst (3)
1- Danazol
2- Tamoxifen
3- Bromocriptine
What are some practical treatments for breast cyst?
1- supportive bra
2- heat
3- cold or gentle massage
4- NSAIDs
What are some dietary guidelines when a patient has breast cyst (2)
1- decrease caffeine
2- Take Vit E or evening Primrose oil
What is Galactorrhea?
Milky nipple discharge unrelated to normal milk production in breast
What medications can cause Galactorrhea (3)
1- Antihypertensive
2- antidepressants
3- antipsychotics
What are some diagnostic test used in working up nipple discharge (3)
1- r/o pregnancy
2- Serum Prolactin
3- TFT
Benign inflammatory condition of increased glandular secretion and dilation of the lactiferous ducts and can be present perimenopausal or post menopausal
Duct Ectasia
How does Duct Ectasia present (2)
1- Unilateral or occasional bilateral, cheesy, viscous nipple discharge
2- Nipple retraction or lump behind nipple
What are some differentials for ductal ectasia?
1- intraductal carcinoma
2- periductal mastitis
3- Pagels disease
This breast abnormality is caused by proliferation and overgrowth of ductal epithelial tissue
Intraductal Papilloma
What age group is intraductal papilloma most common in?
45-50
What type of discharge can be noted in intraductal papilloma?
Bloody, serosanguineous
How does the mass present with intraductal papilloma? (2)
1- Soft, poorly delineated
2- or small, wart-like growth near nipple
Nonpuerperal mastitis characterized by periareolar inflammation with a mass or abscess or a mammary duct fistula
Periductal mastitis
What age group is periductal mastitis often seen in?
reproductive age
How does the breast present in periductal mastitis
1- Reddened, painful nipple or breast with or without mass
2- Nipple retraction or a spontaneous creamy discharge
What is a risk factor for Periductal Mastitis
Smoking
What is the most common female malignancy
Breast Cancer
One in ____ women will develop breast cancer in their lifetime and risk increase with aging
8
What are the risk factors for breast cancer?
1- Female 2- Age 3- Family h/o BRCA 1 & 2 4- early menarche 5- late menopause 6- late or no children 7- ethnicity: white
How is Ductal cancer in-situ
1- Wide surgical excision or mastectomy if extensive
2- radiation to the breast following excision
What is the most common for of breast cancer (70%)
Invasive ductal carcinoma
This type of breast cancer begins in the duct, grows into the surrounding tissue, and has the ability to spread outside of the breast by lymphatics or blood vessels
Invasive ductal carcinoma
How does invasive ductal carcinoma usually present?
as a palpable mass or as an abnormal nodule on a mammogram and/or ultrasound
What is the treatment for Invasive ductal carcinoma? (3)
1- Intitally surgically with wide excision or with mastectomy with surgical evaluation of the lymph nodes
2- Radiation of the remaining breast tissue
3- additional antihormonal or chemo therapy
What is the second most common form of breast cancer? (5-10%)
This type of breast cancer is more likely to present with two or more separate tumors and is more likely to be bilateral than other breast cancers
Invasive lobular carcinoma
This type of breast cancer originates in the lobules, and then invades the surrounding tissue and can spread via the lymph channels or blood stream
Invasive lobular carcinoma
Why is Invasive lobular carcinoma difficult to identify on mammogram therefore making it more advanced when it is diagnosed?
because it resembles the texture and appearance of normal breast tissue
An aggresive form of breast cancer that presents as swelling, redness, warmth, and possible peau d’orange of the breast skin due to blocked lymph drainage from cancer within the del-mar lymphatic system.
Inflammatory breast cancer
What can Inflammatory breast cancer mimic?
Mastitis
What is the treatment of inflammatory breast cancer? (3)
1-Chemo
2-and/or radiation
3- surgery
This type of breast cancer is an uncommon presentation of ductal carcinoma that infiltrate’s the nipple causing changes that range from a rash, itching, redness, flaking, bleeding, or a recurrent scab or nonhealing sore.
Pagets Disease
How is Paget’s Disease diagnosed (3)
1- Breast examination
2- mammogram
3- nipple biopsy
What is the recommended treatment for Paget’s Disease
Mastectomy
What is staging of breast cancer based on (3)
1- tumor size and extension (stage I)
2- Node number and extent (II-III)
3- Distant metastasis (IV)
What is the 5 year survival for stage I
95-100%
What is the 5 year survival for stage II
86%
What is the 5 year survival for stage III
57%
What is the 5 year survival for stage IV
20%
How does Acupuncture help as a complementary therapy in breast cancer treatment?
Gives relief of hot flashes, fatigue and arthralgias
How does physical exercise help as a complementary therapy in breast cancer
effective in relieving fatigue
How does cognitive behavioral therapy help as a complementary therapy in breast cancer treatment?
Effective in the relief of insomnia
