Breast Mass/CA Flashcards
Causes of Breast MAsses
- fibrocystic changes/cysts
- fibroadenoma
- intraductal papilloma
- fat necrosis
- abscess
- malignancy
evaluation if younger than 30 years
-charachteristics of a cyst: monitor x 1-2 menstural cycles or aspirate
if younger than 30, breat mass persists or more suspicious?
-US
if US neg in woman under 30>
observe q 3-6 mnth, considered mammogram
if simple cyst
-reassure, observe or aspirate
if complex cyst?
mammogram
if solid mass?
mammogram:
C3- short ter f/u w/ imaging
C4/5-bx
if age > 30 yo?
unilateral dx mammo and US
if >40 yo?
can get bilateral mammo
Breast Ca
most common female malignancy and the second leading cause of death from CA in women
RF for BCA?
most women have no identifiable RF-
being women, increasing age
-BRCA1 AND 2, associated w. 5-10% of the pts, but only seen in 1% of the population
associated rf for BCA?
nulliparity, early menarche, late menopause, long-term estrogen or radiation exposure, delayed childbearing
what about relatives w/ BCA?
women w/ first degree relatives are at increased risk, especially if the CA was premenopausal or bilateral
relation to endometrial ca?
Breast CA incrases the risk of endometrial and vice versa
what is the most common type of breast ca?
ductal carcinoma (50-80%); the rest are lobular carcinomas
what may presidpose one to breast ca?
lobular CIS and atypical ductal hyperplasia
what is Paget’s dz?
ductal carcinoma presenting as an excematous lesion of the nipple
what is a feature of invasive lobular carcinomas and 2/3 of ductal carcinomas?
estrogen-receptor positive
what are the CF of breast ca?
presents as a single, nontender, firm, immobile mass
-45% occur in the upper outer quadrant, 25% under the nipple and areola
what type can be detected early, but w/ no palpable mass?
early carcinoma
what are rarer presentations of breast ca?
include nipple discharge or retraction,
- dimpling,
- breast enlargement or shrinkage,
- skin thickening or peau d’orange skin,
- eczematous changes, breast pain,
- fixed mass,
- axillary node enlargement, ulceration
- arm edema
- palpable supraclavicular nodes
dx of BCA
- combo of PE, mammo, and fine-needle/stereotactic core needle bx
- US and excisional bx may be indicated
- bx need to undergo estrogen and progesterone receptor analysis and histologic analysis
tx of BCA
-stage before tx
o Breast conservation therapy (lumpectomy), modified radical mastectomy, and partial mastectomy have equivalent survival rates when surgery is followed by radiation therapy
o Adjuvant chemotherapy and/or hormonal manipulation benefit some women
o Tamoxifen is used to treat women with estrogen receptor-positive disease and postmenopausal women
