Chapter 10: Problems of the Breast

Question 1

What is the difference between micromastia and marcomastia?

Answer 1

– micromastia: underdevelopment of breast
– macromastia: hyperplasia or overdevelopment of breast

Question 2

What is the most common benign problem of the breast?

Answer 2

fibrocystic changes of the breast – feeling of lumps or cysts on the breasts

cysts feel movable, soft, and well-defined

Question 3

What is mastalgia?

Answer 3

breast pain

Question 4

What is fibroadenoma?

Answer 4

• most common solid mass of the breast
• discrete, solitary lumps less than 3cm in diameter

Question 5

What is mammary duct ectasia?

Answer 5

• widening of one or more milk ducts
• ducts dilate, fill with endothelial secretions, then common skin bacteria enter and cause mastitis
• s/s: dilated ducts, nipple inversion, pain, greenish nipple discharge

Question 6

What are 2 types of nipple drainage? Which should be investigated further?

Answer 6

1. serous drainage – benign; can occur after stimulation
2. bloody, spontaneous discharge coming from only 1 or 2 ducts – should be investigated

Question 7

What is intraductal papilloma?

Answer 7

• rare, benign condition affecting terminal nipple ducts
• presence of small papillomas that are too small to be palpated
• s/s: bloody discharge
• risk of malignancy –> requires surgical excision

Question 8

When should women receive breast screenings?

Answer 8

• mammograms – annually for 45 - 54; 2x/year for 55+
• BRCA 1 & 2 mutation screenings – 30+; should be done in conjunction with MRI

Question 9

What does the presence of BRCA 1 or 2 gene tell us?

Answer 9

85% chance of development of breast cancer within the woman’s lifetime with either of these genetic mutations

Question 10

What are the 2 most significant prognostic criteria for long-term breast cancer survival?

Answer 10

nodal involvement and tumor size

Question 11

What are the surgical interventions for breast cancer?

Answer 11

• lumpectomy
• mastectomy
• node biopsies

Question 12

What are the 3 types of radiation therapy used for breast cancer treatment?

Answer 12

• accelerated breast radiation therapy
• brachytherapy – internal radiation that destroys cancer cells and shrinks tumors
• partial breast radiation therapy

Question 13

What are 2 adjuvant systemic therapies for breast cancer?

Answer 13

• chemotherapy – administered soon after surgical removal of tumor
• hormonal therapy – antiestrogen medications