Breast Problems Flashcards
Well - circumscribed, rubbery, mobile mass; usually non-tender. Frequently found in upper, outer quadrants.
Fibroadenoma
Rare, large breast tumor that occurs in postmeno women, grows rapidly, and causes disfigurement of the breast. It can be benign or malignant.
Phyllodes Tumor
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.
Fibrocystic Breast Changes
breast mass, skin or nipple retraction; history of trauma, radiation or surgery; may follow fat injections
Fat Necrosis
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
Intraductal Papilloma
lactation unrelated to pregnancy; hormonally induced secretions usually come from multiple duct openings ; typically from a prolactin-secreting adenoma
Galactorrhea
inflammation/infection of the breast; staph aureus is the MC pathogen; clinical presentation is FLS; do lab testing to dx
Mastitis
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
Breast Abscess
occurs occasionally after breast augmentation; inflammation of superficial vein beneath the breast; presents as tender cord
Mondor’s Disease
benign enlargement of breast tissue in males
Gynecomastia
single most important risk factor for breast cancer
age
when do you start a mammogram screening?
at age 40. unless, 1st degree family member was dx. Then you screen 5 years prior to the age they were dx’ed.
which of the diagnostic tests is not used as a screening tool?
Ultrasound!
when is MRI indicated for breast cancer?
only when patient is carrying BRCA 1/2 gene oor if have strong family hx
what procedure uses radioactive substance to view if cancer cells present
scintimammography
- 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
breast thermography
what is the test done for definitive dx of cancer
biopsy (core-needle biopsy preferred)
what is the MC type of breast cancer?
Infiltrating ductal carcinoma (IDC) - 80-90%
which non-invasive cancer is detected on mammography only?
ductal carcinoma in situ
which non-invasive cancer is detected with biopsy only?
lobular carcinoma in situ
starts in milk duct, breaks through wall of duct and grow in fatty tissue of the breast
Infiltrating ductal carcinoma (IDC)
this invasive breast cancer occurs more in older women and the first sign may be thickening on the breast rather than a distinct lump
invasive lobular carcinoma
often misdiagnosed as cellulitis; does not respond to abx; diffuse edema, erythema, firmness of underlying tissue; no palpable mass; orange like skin
inflammatory breast carcinoma
first sx is itching/burning of nipple, superficial erosion/ulceration; characterized by eczematoid changes of nipple. over 85% associated with another cancer.
Paget’s Disease
if sentinal node contains cancer, what node needs to be dissected?
axillary
Lymphedema Prevention: patient education involves:
- avoid having blood drawn from arm on side of node surgery
- do not allow a BP cuff to be placed on that arm
most commonly used anti-estrogen med:
tamoxifen
- Highly targeted, highly effective
- Shrinks tumor before surgery or destroys residual cancer cells
- Reduces risk of recurrence
- Relatively easy to tolerate
Radiation
- based on lymph node status
- decreased risk of recurrence and morbidity
Chemotherapy
