Breasticles Flashcards
Milk is created within the glands of the
alveoli
Many alveoli in a bundle form a
lobule
Many lobules in a bundle form a
lobe
______ connect the lobules and the lobes to the ____
ducts, nipple
3 types of breast tissue
Fat
Glandular
Fibrous stroma (and supporting structures)
As a woman ages, glandular tissue is gradually replaced by
fatty tissue
95% of breast cancer begins in what part/tissue of breast
Breast Ducts (connect lobules to areola/nipple)
breast ducts are part of the glandular tissue
60% of arterial supply to breast comes from
Internal Mammary Artery
30% of arterial supply to breast comes from
Lateral thoracic artery
3 veins that provide vascular return from breast
Axillary vein * (primary)
Internal mammary vein
Intercostal veins
75% of lymphatic drainiage from breast goes to
Axillary lymphatic nodes
Lymphatic drainage for the breast can cross over to the opposite breast via which nodes
Internal mammary nodes (sternal border)
Nontender, slow growing breast mass, no nipple discharge.
DDX?
Fibroadenoma
Phylloides tumor Breast Cyst Traumatic fat necrosis Carcinoma
Benign solid tumor, a proliferative process in a single lobule.
Etiology uncertain. Possible hormonal. Malignant transformation is rare.
Fibroadenoma
On PE, rubbery, mobile, painless mass.
Can be simple, solitary, and small (<1 cm)
or multiple, large (>5 cm)
Fibroadenoma
Fibroadenoma on ultrasound
solid mass
Often confused with a fibroadenoma, but more often found in an older age group (40-50yrs old). Rapid growth. Large, leaf-like projections
Phyllodes tumor
Phyllodes tumor - benign or malignant?
60-70% benign. Can borderline malignant
On PE: smooth, multinodular, well-defined, firm. Mobile and painless. Can range from 4cm-40cm
Phyllodes tumor
Further dx for phyllodes tumor
Ultrasound
Mammography (smooth polylobulated mass resembling a fibroadenoma)
Cytology (biospy)
Phyllodes tumor tx
wide local excisional biopsy
“nonintegrated involution of breast tissue”
breast cyst
On PE, firm, smooth, discrete, often tender mass
Breast cyst
Pain and lump in breast. Hx of local trauma (seatbelt, blunt trauma, surgery)
traumatic fat necrosis
Cystic enlargement of glandular and connective tissue of breasts
Fibrocystic breast changes
Bloody ductal d/c
Intraductal papilloma
Duct extasia
(ductal cancer)
Bloody discharge is suggestive of _____ but most likely _____
cancer; intraductal papilloma
Often asymptomatic, can cause green/black discharge. May have mass, inflammation of nipple and surrounding tissue
Duct Ectasia
2 chronic medical conditions and 1 medication that can cause benign milk discharge (no pregnancy)
Pituitary adenoma
Hypothyroidism
Dopamin antagonists
Localized inflammation of breast associated with fever, myalgias, breast pain and redness
Mastitis
Tx for mastitis
aside from supportive care…
Dicloxacillin or cephalosporin for 10-14 days
2nd most common cancer in women
2nd leading cause of cancer death in women
BREAST (skin is 1st)
BREAST (lung is 1st)
Screening mammography recommendation
Annually > 40yrs
Or 10 years younger than diagnosed family member
Enhanced screening for BRCA 1 BRCA2 pos
Monthly breast self-exam starting 18yrs
Semiannual clinical breast exam starting 25 yrs
Annual MRI / mammography starting 25 yrs
breast cancer chemoprevention drug
Tamoxifen
Risks/side effects of tamoxifen
increased endometrial cancer and DVT, cataracts, depression, vasomotor symptoms, vaginal dryness/discharge
Breast cancer staging
Stage 0 –carcinoma in situ
Stage I – tumor < 2 cm, no nodes
Stage II—tumor 2-5 cm, +/- nodes*
Stage III – locally advanced disease, fixed or matted lymph nodes and variable tumor size**
Stage IV – distant metastases (bone, liver, lung, brain)
