Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3a womens health > Breast Medicine > Flashcards

Breast Medicine Flashcards

1
Q

What is fibroadenoma?

A

Benign tumour of the breast.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the histology of fibroadenoma

A

● glandular epithelium and interlobular stroma of a terminal duct lobular units
● Well-circumscribed, non-encapsulated.
● Does not infiltrate into the parenchyma of the breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give 4 differentials for a breast lump

A

Breast carcinoma.
Fibroadenoma.
Breast abscess.
Breast cyst.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does fibroadenoma present

A

Solitary, mobile breast lump with a regular border.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is fibroadenoma investigated

A

1st line - breast imaging (USS or mammogram)

Women <30: breast ultrasound.
● Smooth, well-circumscribed mass with uniform hypoechogenic
appearance.

■ Women >30 or highly suspicious for cancer: mammogram.
● Distinct, well-circumscribed mass.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Mastitis?

A

inflammation of the breast tissue, typically due to infection.

Divided into lactational and non-lactational (duct ectasia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a Breast Abscesses?

A

An encapsulated accumulation of pus within the breast tissue due to infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the cause of Lactational mastitis

A

Combination of breastfeeding-related nipple trauma and milk stasis predisposes the breast to local infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the cause of Duct ectasia mastitis

A

Blockage of lactiferous ducts due to squamous metaplasia leads to dilatation and inflammation.

Strongly associated with cigarette smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does duct ectasia mastitis present

A

Nipple discharge
Tenderness or pain
Nipple retraction or inversion
A breast lump (pressure on the lump may produce nipple discharge)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the cause of breast abscess

A

Progression of untreated infective mastitis; walled-off collection of infection forms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do Mastitis and Breast Abscesses present?

A

● Symptoms include: fever, breast pain / tenderness (often during breastfeeding)
● Signs include: erythema, swelling, firmness.
● Duct ectasia is also associated with nipple discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is Mastitis investigated

A

usually a clinical diagnosis based on history and examination findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is Breast Abscesses investiagted

A

breast ultrasound and diagnostic needle
aspiration.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is Lactational Mastitis managed

A

○ First Line: continued breastfeeding / milk expression plus simple analgesia
○ Second Line: >24 hour duration / severe pain - add PO flucloxacillin.

erythromycin when allergic to penicillin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is most common bacterial cause of Mastitis

A

Staphylococcus aureus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is Non-lactational Mastitis managed

A

First line: PO flucloxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How are Breast Abscess managed

A

First Line: needle aspiration and drainage plus flucloxacillin (dependent on local
policy).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why is the incidence of breast cancer thought to be increasing?

A

Western lifestyle.
Screening.
Increasing life expectancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What percentage of women who have a mammogram will be called back for more tests?

A

4/100 will need more tests.

1/4 of these women will then be found to have cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name 3 modifiable RF’s for breast cancer.

A

Alcohol intake.
Obesity.
Use of HRT/OCP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name 3 non-modifiable RF’s for breast cancer.

A
  • Age of menarche/menopause
  • Breast density.
  • Genetics e.g. BRCA1/2
23
Q

Approximately what percentage of breast cancers are ductal and what percentage are lobular?

A

Ductal (70%).
Lobular (10%).

24
Q

What are the non invasive breast cancers

A

Ductal carcinoma in situ (DCIS)
Lobular carcinoma in situ (LCIS)

25
Q

Difference between invasive and non invasive breast cancer

A

Invasive = penetration through basement membrane

26
Q

What are the invasive breast cancers

A

Invasive ductal carcinoma (commonest - 75%)
Invasive lobular carcinoma
Medullary carcinoma

27
Q

What is Pagets disease of the nipple

A

Looks like eczema of the nipple/areolar
Indicates breast cancer involving the nipple
May represent DCIS or invasive breast cancer

28
Q

Give 4 signs that you may find on clinical examination that are suggestive of breast cancer.

A

Palpable lump - irregular, hard, fixed, painless.
Discharge from the nipple.
Nipple in-drawing.
Skin changes e.g. peau d’orange.

29
Q

How is breast cancer graded

A

Nottingham criteria:

○ Gland formation
○ Nuclear atypia / pleomorphism
○ Mitosis counts (indicates rate of cellular reproduction)

30
Q

What are the steps for metastatis

A
  1. Invasion through basement membrane
  2. Intravasation (entry into circulation)
  3. Circulation
  4. Extravasation
  5. Colonisation
31
Q

Common met locations for breast cancer

A

bones, liver, lungs and brain.

32
Q

What is the screening program for breast cancer

A

3-yearly mammogram for women aged 50-71.

33
Q

Breast cancer: what is the triple assessment?

A

Clinical examination e.g. palpation.
Mammogram.
Core needle biopsy.

34
Q

If a patient has breast implants or high density breasts a mammogram can be difficult to interpret. What investigation can be done as an alternative?

A

MRI

35
Q

Breast cancer: is a P1/2 lump that is described as soft, mobile and regular likely to be benign or malignant?

A

Benign. E.g. fibroadenoma.

36
Q

Breast cancer: is a P4/5 lump that is described as hard, fixed and irregular likely to be benign or malignant?

A

malignant

37
Q

What are the typical mammogram findings of malignant carcinoma

A

● Pre-invasive: unifocal / widespread microcalcifications

● Invasive carcinoma:
1. Irregular spiculated mass
2. Clustered microcalcifications
3. Linear branching calcifications.

38
Q

Give 3 treatment options for patients with breast cancer.

A
  1. Conservative surgery + radiotherapy.
  2. Mastectomy + radiotherapy.
  3. Mastectomy + reconstruction + radiotherapy (BUT can damage a lot of reconstructions).
  4. Axillary lymph node removal - limited removal or clearance.
39
Q

Why might a mastectomy be indicated as opposed to a lumpectomy in someone with breast cancer?

A

If the tumour is large relative to the size of breast.
If there are multiple tumours.
Patient preference.

40
Q

What biopsy should you do to ensure that breast cancer hasn’t spread to the axillary lymph nodes?

A

A sentinel node biopsy.

41
Q

Name 2 adjuvant treatments that can be given to women with oestrogen receptor positive cancer.

A
  • Tamoxifen (pre-menopausal).
  • anastrozole - Aromatase inhibitors (post-menopausal).
42
Q

What is triple-negative breast cancer

A

when the breast cancer cells do not express any of these three receptors
worse prognosis

Oestrogen receptors (ER)
Progesterone receptors (PR)
Human epidermal growth factor (HER2)

43
Q

Name 2 adjuvant treatments that can be given to women with HER2 receptor positive cancer.

A

Trastuzumab (Herceptin)

44
Q

Name 3 Breast Cancer Receptors

A

Oestrogen receptors (ER)
Progesterone receptors (PR)
Human epidermal growth factor (HER2)

45
Q

What is in the criteria for high risk breast cancer

A
  • BRCA1, BRCA2 genes - 40% lifetime risk of breast/ovarian cancer
  • 1st degree relative premenopausal relative with breast cancer (e.g. mother)
  • nulliparity, 1st pregnancy > 30 yrs (twice risk of women having 1st child < 25 yrs)
  • early menarche, late menopause
  • combined hormone replacement therapy
  • past breast cancer
  • not breastfeeding
  • ionising radiation
  • p53 gene mutations
  • obesity
  • previous surgery for benign disease (?more follow-up, scar hides lump)
46
Q

What is the two week criteria for breast cancer

A
  • Unexplained breast or axillary lump in a woman aged >30.
  • Unilateral nipple changes in a woman aged >50.
  • Skin changes suggestive of breast cancer, any age.
47
Q

What is a complication of axillary lymph node clearence

A

Chronic Lymphoedema

48
Q

What is Intraductal Papilloma

A

a warty lesion that grows within one of the ducts in the breast.
proliferation of epithelial cells

49
Q

How does Intraductal Papilloma present

A

Nipple discharge (clear or blood-stained)
Tenderness or pain
A palpable lump

50
Q

how is Intraductal papillomas managed

A

complete surgical excision.

51
Q

How do breast cysts feel on examination

A

Smooth
Well-circumscribed
Mobile
Possibly fluctuant

52
Q

What are the options for reconstructing the breast after mastectomy?

A

Breast implants
Flap reconstruction

53
Q

Name side effects of radiotherapy

A

General fatigue from the radiation
Local skin and tissue irritation and swelling
Fibrosis of breast tissue
Shrinking of breast tissue
Long term skin colour changes (usually darker)

3a womens health (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions