Breasts Flashcards
Current recommendations regarding self-breast exams (SBE)
USPSTF - not recommended ACA - not recommended ACOG - encourage breast self-awareness
Current USPSTF recommendations regarding breast cancer screening
Mammography
50 to 74 - biennially
<50 individualize screening - pt specific
>/=75 insufficient evidence
CBE - >/= 40, insufficient evidence
Seven characteristics of a breast nodule that should be described
- Location - by quadrant or o’clock - w/ cm from nipple
- Size - in cm
- Shape - round or cystic, disc-like, or irregular
- Consistency - soft, firm, hard
- Delimitation - well circumscribed or not
- Tenderness
- Mobility - in relation to the skin, pectoral fascia, and chest wall; gently move the breast near the mass and watch for dimpling
A smooth, rubbery, round, mobile, non-tender breast mass
Fibroadenoma (age 15-25)
A soft or firm, round, mobile and often tender breast mass in a 38 year old female.
Cyst (age 30-50)
Your 68 year old female patient has an irregular, firm, non-tender breast nodule that is not clearly delineated from surrounding tissue.. you suspect:
Breast cancer until ruled out
What are some visible signs of breast cancer?
- Redness
- Skin thickening - peau d’orange sign
- Prominent pores
- Flattening
- Asymmetry/change in nipple direction
- Eczematous changes w/ rash, scaling, or ulceration
- Nipple retraction - may be depressed, flat, broad, or thickened
- Abnormal contours
Milky nipple discharge unrelated to pregnancy or lactation
Galactorrhea - more likely to be pathologic if bloody or serous, unilateral, spontaneous, associated w/ a mass, and occurring in women >/= 40yrs
Nipple discharge that is usually bilateral, multi-ductal, prompted by stimulation and ranges in color from white to yellowish, green or black indicates what?
physiologic nipple discharge (normal)
What are considered normal findings in the breasts of newborns?
Often enlarged, both in males and females from maternal estrogen effect - this may last several months Breasts may be engorged w/ a white liquid which may last 1 to 2 weeks
Current ACA (Amer. Cancer Society) recommendations for breast cancer screenings
Mammo
40y - 45y- optional annual screening
45y - 54y- annual screening
>/= 55 - biennial screening w/ option to continue annual screens - continue if health/life expectancy >/= 10 years
CBE Not recommended
How to assess the lateral portion of the breast
Hand on forehead with shoulders against the bed (flattens tissue)
What is premature thelarche?
Breast development in a girl, most often between 6mo and 2yrs without other signs of puberty or hormone abnormalities
Padet Disease of the Nipple
a scaly, eczema-like lesion on the nipple that may weep, crust, or erode
Breast mass in a patient age 25-50, consider
Cyst
What is the most important risk factor for developing breast cancer?
The most important risk factor is AGE - other risk factors include family hx and ovarian CA
Your 61-year-old female patient presents with a chief complaint of spontaneous, unilateral bloody nipple discharge. As her FNP, you know this warrants further evaluation for:
Intraductal papilloma
Benign breast development in men
gynecomastia
A breast mass in a female age 50 or older is always considered this until proven otherwise
Breast cancer
Breast mass in a patient age 15 to 25, consider
Fibroadenoma
How to assess the medial portion of the breast
Hand on neck with shoulders against the bed
Current ACOG (Amer. Colleg of OB/GYN recommendtions for breast cancer screenings
Mammo
>/= 40y- annually
CBE
20y-39y every 1-3 years
>/= 40 - annually
Describe the location of the following breast mass
3cm mass in the upper outer quadrant of the left breast at 1 o’clock, approximately 2cm from the nipple
A 40yo female presents with a single, round, soft, well-deliniated, mobile, tender breast mass. What is the most likely diagnosis?
Breast Cyst
An uncommon form of breast cancer that causes crusting, weeping and erosion of the nipple and/or areola
Paget’s disease
