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CLASS 22010 GU > BREAST MASS > Flashcards

BREAST MASS Flashcards

1
Q

What are known as painful breast masses, often multiple and bilateral, and pain often worsens during the premenstrual phase of cycle?

A

Fibrocystic condition (fibrocystic changes)

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2
Q

Is rapid fluctuation in breast mass size normal?

A

yes

  1. estrogen is considered a causative factor
  2. increased risk in women who drink
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3
Q

What is the most frequent lesion of the breast?

A

Fibrocystic condition (fibrocystic changes)

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4
Q

What is the most common age for fibrocystic changes?

A

30-50 years old

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5
Q

What are these signs and symptoms of?

  1. breast pain or tenderness
    a. may be asymptomatic and found on accident
  2. discomfort often worsens during premenstrual phase of cycle as cysts are enlarging
  3. fluctuation in size of masses
  4. multiple or bilateral
  5. absence of enlarged or tender lymph nodes
A

Fibrocystic changes

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6
Q

What imaging should be used for fibrocystic changes?

A
  1. mammography
  2. ultrasound
    a. used alone when patient is under 30
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7
Q

What kind of diagnostic testing should be performed for all suspicious lesions?

A

Core needle biopsy

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8
Q

Can you treat fibrocystic changes with NSAIDS?

A

yes, but more severe pain should be referred to primary care for further eval

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9
Q

What are some patient education points for fibrocystic changes?

A
  1. avoiding trauma
  2. wear supporting bra day and night
  3. decrease fat intake
  4. eliminating caffeine
  5. Vitamin E, 400IU daily
  6. Month self breast exam after menstruation
    a. risk of not detecting breast cancer is higher
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10
Q

What is a common benign neoplasm of the breast occurring most frequently in young women?

A

Fibroadenoma

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11
Q

What usually occurs within 20 years after puberty and more frequently and occurs earlier in black women?

A

Fibroadenoma

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12
Q

What are these mass characteristics indicative of?

  1. round or ovoid
  2. rubbery
  3. discrete
  4. relatively movable
  5. nontender mass 1-5 cm in diameter
A

Fibroadenoma

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13
Q

What kind of imaging should be done for fibroadenomas?

A

ultrasound

1. core needle biopsy often recommended

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14
Q

True or False

All breast masses should be referred to General surgery for further evaluation and work up

A

True

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15
Q

Once a fibroadenoma is confirmed with biopsy, is treatment usually necessary?

A

No

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16
Q

Excision may be necessary for large or rapidly growing fibroadenomas of what size?

A

larger than 3-4cm

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17
Q

Excision of fibroadenomas is used to rule out what?

A

phyllodes tumor

1. rare malignant fibroadenoma like tumor

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18
Q

What is a lesion of the breast, produces a mass (often with skin or nipple retraction), and are commonly seen after fat injection to augment breast size or to fill defects after breast surgery?

A

Fat necrosis

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19
Q

What is usually indistinguishable from carcinoma even with imaging studies?

A

Fat necrosis

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20
Q

What is usually presumed to be the cause of fat necrosis?

A

trauma

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21
Q

Untreated masses from fat necrosis gradually disappear, but the safest course is to obtain a what?

A

core needle biopsy

frequently entire mass must be excised to exclude carcinoma

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22
Q

These can be common causes of what in the breast?

  1. segmental resection
  2. radiation therapy
  3. flap reconstruction after mastectomy
  4. MVA
  5. Assault
A

Fat necrosis

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23
Q

What disease has a 1 in 8 incidence in american women?

A

Female breast carcinoma

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24
Q

What is the second most common cancer in women?

A

Female breast carcinoma

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25
Q

What is the second leading cause of cancer death?

A

Female breast carcinoma

26
Q

What is the most significant risk factor for female breast carcinoma?

A

Age

27
Q

Risk for female breast carcinoma rises rapidly until early in the ____, peaks in the ____, then declines.

A
  1. 60’s

2. 70’s

28
Q

What genetic factors are increased risk factors for female breast carcinoma?

A
  1. BRCA 1

2. BRCA 2

29
Q

Are nulliparous women or women with a late first pregnancy (after 30 y/o) at an increased risk for female breast carcinoma?

A

Yes

30
Q

True or False

Early menstruation (before 12) or late menopause (after 55) can be a risk factor for female breast carcinoma

A

True

31
Q

What is the most reliable means of detecting breast cancer before a mass can be palpable?

A

Mammography screening

32
Q

Most slow growing cancer can be identified by what, at least two years before they are palpable?

A

mammography

33
Q

Is mammography recommended in women under 40 with average risk?

A

No

34
Q

Should women aged 40-49 get a mammography?

A

it should be a shared decision with the patient

suggest screening every 2 years if they decide to

35
Q

How often are women aged 50-74 recommended to get screening mammographies?

A

every 2 years unless otherwise indicated

36
Q

How often is a mammography recommended for a woman 75 or older?

A

only if life expectancy is greater than 10 years

37
Q

What kind of imaging is used for possible female breast carcinoma and may be useful to those who are high risk, but is not for the general population?

A
  1. MRI

2. Ultrasound

38
Q

Are self breast exams shown to improve survival?

A

No

39
Q

What percentage of patients present with a (usually) painless lump of the breast in the early symptoms of possible female breast carcinoma?

A

70%

1. about 90% are found by the patient

40
Q

These are less frequent symptoms of what?

  1. breast pain
  2. nipple discharge
  3. erosion, retraction, enlargement, or itching of the nipple
  4. redness, generalized hardness, enlargement, or shrinking of the breast
A

Female breast carcinoma

41
Q

Female breast carcinoma rarely presents with what?

A
  1. axillary mass or swelling
  2. back or joint pain
  3. jaundice
  4. weight loss
42
Q

Are these late or early signs of female breast carcinoma on exam?

  1. single, non-tender, firm to hard mass with ill-defined margins
  2. mammographic abnormalities with no palpable mass
A

Early

43
Q

Are these late or early signs of female breast carcinoma on exam?

  1. skin or nipple retraction
  2. axillary lymphadenopathy
  3. breast enlargement, erythema, edema, pain
  4. fixation of mass to skin or chest wall
A

Late

44
Q

What are some lab findings seen in female breast carcinoma?

A
  1. increased alkaline phosphate
    a. liver or bone metastases cause elevation
  2. increased serum calcium
    a. elevated in bone metastases
45
Q

When is a diagnostic mammography used in possible female breast carcinoma ?

A

when the abnormality is only felt by patient

46
Q

True or False

MRI’s have a false negative rate of 3-5% for the detection of female breast carcinoma

A

True

47
Q

What is the diagnostic procedure of choice in both palpable and image detected abnormalities of the breast in suspected female breast carcinoma?

A

Core needle biopsy

48
Q

All breast masses should be referred to where for further evaluation and work up?

A

general surgery

49
Q

What does the treatment of female breast carcinoma depend on?

A

stage of the cancer

  1. surgical resection
  2. radiation
  3. systemic therapy
    a. chemo
    b. targeted therapy
    c. bisphosphonates
50
Q

True or false

The stage of female breast carcinoma is the most reliable indicator of the prognosis. More aggressive are associated with worse outcomes in younger women

A

True

51
Q

Local and distant recurrences of female breast carcinoma occurs most frequently within the first how many years?

A

2-5 years

52
Q

During the first two years following primary therapy of female breast carcinoma, most patients should be examined how often?

A

every 6 months and annually thereafter

53
Q

A new primary breast malignancy will develop in what percentage of patients after primary therapy of female breast carcinoma?

A

20-25%

54
Q

What form of cancer has an incidence rate of about 1% of all breast cancer?

A

male breast carcinoma

55
Q

What is the average age of occurrence with male breast carcinoma?

A

70

56
Q

There is an increased incidence of male breast carcinoma in men with what?

A

prostate cancer

57
Q

What gene mutation is common in men with breast cancer?

A

BRCA 2

58
Q

A male patient presenting with a painless lump that is hard, ill defined, nontender mass beneath the nipple or areola, and gynecomastia may be what?

A

male breast carcinoma

59
Q

What are some treatments for male breast carcinoma?

A
  1. modified radical mastectomy
  2. radiation
  3. adjutant systemic therapy
    a. chemo
    b. targeted therapy
60
Q

What is the 5 year survival rate for men with male breast carcinoma with node negative disease?

A

88%

61
Q

What is the 5 year survival rate for men with male breast carcinoma with node positive disease?

A

69%

CLASS 22010 GU (41 decks)

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