Breasts Flashcards
Supernumerary nipple/ breasts- location
Along milk line
not dangerous
Supernumerary nipple/ breasts- signs and symptoms
Darken during pregnancy
Increase in size/lactation during pregnancy
Gynecomastia- what is it?
Unwanted enlargement/swelling of breast tissue
Gynecomastia - risk factors
M- puberty
Elderly- decreased testosterone
Gynecomastia - indicates what?
Hormone imbalance- increased estrogen
Mastodynia (mastalgia)- risk factors
W taking OCPs or HRT
Mastodynia (mastalgia)- cause
Hormonal changes- cyclical
Mastodynia (mastalgia)- signs and symptoms
Tenderness/pain
Luteal phase
Mastodynia (mastalgia)- treatment
Vit B6 and Vit E
Mastitis- what is it?
Breast infection
Mastitis - risk factors?
Lactating
Mastitis - cause
Staph aureus
Mastitis - signs and symptoms
Abscess
Poor latch or incomplete emptying of breast
Unilateral tenderness
Heat
Significant fever/chills
Body aches (flu-like/ cellulitis type symptoms)
Mastitis- what is affected?
Usually one quadrant of breast/lobule affected
Mastitis- labs and imaging
Culture of purulent milk - NOT done
Mastitis- treatment
Dicloxacillin Cephalosporin Warm compress Continue breastfeeding Surgical or I&D- if abscess
Breast abscess- develops when?
During lactation
Breast abscess - signs and symptoms
Painful
Swollen area of redness
Tenderness
Induration (filled w pus)
Breast abscess- what may develop in non-lactating W? and why?
Subareolar abscess
From nipple piercing
Breast abscess- treatment
I & D
Dicloxacillin= abx
Breast abscess- what if no response to tx?
suspect inflammatory breast cancer- especially if associated w axillary lymphadenopathy
Fat necrosis of the breast- what is it?
Benign- damaged/dead breast tissue
Fat necrosis of the breast - risk factors/cause
Trauma
After breast bx, radiation, surgery
Fat necrosis of the breast- signs and symptoms
Firm nodule
Fat necrosis of the breast - tests and imaging
Bx
May look like breast carcinoma on imaging
Fat necrosis of the breast- treatment
Excision is not needed
Fat necrosis of the breast and risk of cancer
NO increased risk
Fibrocystic breast changes / disease- what is it?
MC benign condition of breast
Fibrocystic breast changes / disease - risk factors
30-50
Denser breast
Fibrocystic breast changes / disease - cause
Hormonal changes that produce lumps
Fibrocystic breast changes / disease - signs and symptoms
Bilateral pain and size fluctuation during period
Mobile
Cyclic pain or breast tenderness
Fibrocystic breast changes / disease- when do symptoms subside? and why?
At menopause- no more hormonal changes w menstrual cycle
Fibrocystic breast changes / disease vs carcinoma
Multiple lesions usually distinguish from carcinoma but any suspicious lesion should be biopsied or excised
- straw colored or green fluid
Fibrocystic breast changes / disease- treatment
Supportive bra Caffeine avoidance Low salt diet Vitamin E Evening primrose oil
Fibroadenoma- what is it?
Benign tumor of glandular breast tissue
Second most common benign breast disorder
Fibroadenoma- risk factors
Young W
Black W
Fibroadenoma- signs and symptoms
Round or ovoid Firm Smooth Rubbery Discrete Mobile Non tender Painless
Fibroadenoma- diagnosis
Core needle bx or
3-6 m follow up w repeat US and breast exam
Fibroadenoma- treatment
No tx if dx made by core needle bx
May surgically remove if pt wants
Cryoablation is an alternative (destroy tissue)
Galactorrhea- result of/ cause?
Hyperprolactinemia (meds or tumor)
Galactorrhea- signs and symptoms
Milky white discharge
Bilateral= CNS
Pathologic nipple discharge- types
Duct ectasia (duct itself- thicker walls)
Intraductal papilloma (benign tumor in duct or bv)
Carinoma
Pathologic nipple discharge - signs and symptoms
Unilateral- single duct
Serous, bloody or serosanguineous (combo)
Purulent w breast abscess
Pathologic nipple discharge- imaging/ tests
Cytology exam of nipple discharge rarely helpful bc negative does not rule out cancer
U/S/ mammogram
Pathologic nipple discharge - what is considered diagnosis and treatment?
Surgical excision of involved duct
Lactation- breast milk contents
Right amount of fat, sugar, water, protein, and minerals needed for baby’s grown and development
Changes as baby grows to adapt to baby’s needs
Antibodies- that protect infants from certain illnesses
Lactation- breast changes in pregnancy
hormonal dependent growth- growth and branching of the ductal system and fat deposition
- estrogen, prolactin, growth hormone, adrenal glucocorticoid, insulin
Lactation- let down reflex prolactin
Released by ant pit- stimulated by signals from nipple to hypothalamus mammary glands to start producing milk//milk secretion- stimulates colostrum
Lactation- let down reflex oxytocin
Released by ant pit- stimulated by signals from suckling or crying - stimulates smooth muscle contraction, helps eject milk- milk letdown from the mammary gland of the breast into the ductal system
Lactation- breast feeding recommendations
Breastfeeding first 6m followed by combo w complementary foods until 12m and continuation until desired
