Breast Problems

Question 1

Well - circumscribed, rubbery, mobile mass; usually non-tender. Frequently found in upper, outer quadrants.

Answer 1

Fibroadenoma

Question 2

Rare, large breast tumor that occurs in postmeno women, grows rapidly, and causes disfigurement of the breast. It can be benign or malignant.

Answer 2

Phyllodes Tumor

Question 3

MC in pre-meno women; breast tissue often nodular with dense texture; frequently tender when palpated; mammogram for older, US for younger may be helpful; definitive DX made with core needle biopsy.

Answer 3

Fibrocystic Breast Changes

Question 4

breast mass, skin or nipple retraction; history of trauma, radiation or surgery; may follow fat injections

Answer 4

Fat Necrosis

Question 5

benign; usually unilateral and solitary tumor; forms in lactiferous ducts; occurs in premeno women; small lump near the nipple; MC cause of bloody nipple discharge

Answer 5

Intraductal Papilloma

Question 6

lactation unrelated to pregnancy; hormonally induced secretions usually come from multiple duct openings ; typically from a prolactin-secreting adenoma

Answer 6

Galactorrhea

Question 7

inflammation/infection of the breast; staph aureus is the MC pathogen; clinical presentation is FLS; do lab testing to dx

Answer 7

Mastitis

Question 8

often have history of mastitis; caused by staph aureus; if non-lactating, work up for breast cancer (inflammatory carcinoma); > 30 years and already given birth, tobacco use is significant risk; local and system infection signs; palpable mass

Answer 8

Breast Abscess

Question 9

occurs occasionally after breast augmentation; inflammation of superficial vein beneath the breast; presents as tender cord

Answer 9

Mondor’s Disease

Question 10

benign enlargement of breast tissue in males

Answer 10

Gynecomastia

Question 11

single most important risk factor for breast cancer

Answer 11

age

Question 12

when do you start a mammogram screening?

Answer 12

at age 40. unless, 1st degree family member was dx. Then you screen 5 years prior to the age they were dx’ed.

Question 13

which of the diagnostic tests is not used as a screening tool?

Answer 13

Ultrasound!

Question 14

when is MRI indicated for breast cancer?

Answer 14

only when patient is carrying BRCA 1/2 gene oor if have strong family hx

Question 15

what procedure uses radioactive substance to view if cancer cells present

Answer 15

scintimammography

Question 16

• Combines advanced digital technology with ultra-sensitive infrared camera imaging
• Detects patterns of heat emitted from the blood vessels in breasts
• Not a substitute for mammogram

Answer 16

breast thermography

Question 17

what is the test done for definitive dx of cancer

Answer 17

biopsy (core-needle biopsy preferred)

Question 18

what is the MC type of breast cancer?

Answer 18

Infiltrating ductal carcinoma (IDC) - 80-90%

Question 19

which non-invasive cancer is detected on mammography only?

Answer 19

ductal carcinoma in situ

Question 20

which non-invasive cancer is detected with biopsy only?

Answer 20

lobular carcinoma in situ

Question 21

starts in milk duct, breaks through wall of duct and grow in fatty tissue of the breast

Answer 21

Infiltrating ductal carcinoma (IDC)

Question 22

this invasive breast cancer occurs more in older women and the first sign may be thickening on the breast rather than a distinct lump

Answer 22

invasive lobular carcinoma

Question 23

often misdiagnosed as cellulitis; does not respond to abx; diffuse edema, erythema, firmness of underlying tissue; no palpable mass; orange like skin

Answer 23

inflammatory breast carcinoma

Question 24

first sx is itching/burning of nipple, superficial erosion/ulceration; characterized by eczematoid changes of nipple. over 85% associated with another cancer.

Answer 24

Paget’s Disease

Question 25

if sentinal node contains cancer, what node needs to be dissected?

Answer 25

axillary

Question 26

Lymphedema Prevention: patient education involves:

Answer 26

• avoid having blood drawn from arm on side of node surgery

- do not allow a BP cuff to be placed on that arm

Question 27

most commonly used anti-estrogen med:

Answer 27

tamoxifen

Question 28

• Highly targeted, highly effective
• Shrinks tumor before surgery or destroys residual cancer cells
• Reduces risk of recurrence
• Relatively easy to tolerate

Answer 28

Radiation

Question 29

• based on lymph node status

- decreased risk of recurrence and morbidity

Answer 29

Chemotherapy