Chapter 17: Breasts

Question 1

Between what ribs are the breasts found

Answer 1

Between the second and sixth rib

Question 2

What are the small elevated sebaceous glands surrounding the areola

Answer 2

Montgomery glands

Question 3

What are the 5 sections of the breast?

Answer 3

Upper inner quadrant, upper outer quadrant, lower inner quadrant, lower outer quadrant, axillary tail of spence

Question 4

Is it normal for infants and children to have engorged breast tissue?

Answer 4

Yes

Question 5

What is Witch’s milk?

Answer 5

Normal secretions of milky substance from an infant

Question 6

What stimulates breast changes at puberty?

Answer 6

Estrogen

Question 7

Does breast development or menarche come first?

Answer 7

Breast development

Question 8

When do breast changes occur in pregnant women?

Answer 8

Around 2 months in

Question 9

Colustrum

Answer 9

Breasts produce colostrum for first few days after delivery

Question 10

When does lactation usually occur?

Answer 10

1 to 3 days postpartum

Question 11

What are nipple and breast changes in pregnant women?

Answer 11

Striae
Blue vascular pattern is visible over the breasts..
Nipples become darker and more erectile.
Areolae widen; grow darker

Question 12

After menopause what secretions decrease, leading to breast glandular tissue to atrophy?

Answer 12

Ovarian secretion od estrogen and progesterone

Question 13

Women over what age have an increased risk of breast cancer?

Answer 13

50 yrs

Question 14

Gynecomastia

Answer 14

The temporary enlargement of breast tissue in boys during adolescence
Can be due to medication, usually unilateral, may also be seen in the aging male due to testosterone deficiency

Question 15

Menses usually begins around what age on average?

Answer 15

12

Question 16

Does obesity contribute to early onset of puberty

Answer 16

Yes

Question 17

Precocious puberty

Answer 17

9 for boys

8 for girls

Question 18

When should breast cancer screening start?

Answer 18

Around 40

Question 19

Breast cancer prevalence in A.A and Caucasians

Answer 19

A.A have a higher mortality rate with breast cancer and higher rate before 45
Caucasians have a higher rate after 45

Question 20

Signs of breast cancer in the breast

Answer 20

Pain, Lump, Discharge, Rash, Swelling, Trauma

Question 21

Signs of breast cancer in the axilla

Answer 21

Tenderness, lump or swelling, rash

Question 22

What are you inspecting for when looking at the areola and nipples

Answer 22

Nipple
Symmetry
Nipple variations/positions
Note any dry scaling, ulceration, and bleeding or other discharge.

Question 23

Should you examine the axillae while the woman is sitting or standing?

Answer 23

Sitting and also check the lymphatic draining areas

Question 24

What are the two patterns to use when examining the breast

Answer 24

Vertical strip and concentric circle

Question 25

When should you do a self breast exam?

Answer 25

In the shower after your period because that is when the breast are smallest and is at normal baseline

Question 26

When should you do a self breast exam if you are a menopausal woman?

Answer 26

Same day each month

Question 27

Risk factors for breast cancer

Answer 27

Advanced age, History of breast cancer, first degree relative with breast cancer, BRCA-1 or BRCA-2, Menarche at an early age, Hormone therapy (or high levels of estrogen), HRT, No children or having children late, Obesity, Smoking, Atypical hyperplasia

Question 28

Dimpling

Answer 28

Nipple retraction which makes the nipple look flat, may only be apparent with lifted arms, laying down or with compression

Question 29

Edema (Peau d’Orange)

Answer 29

Lymphatic obstruction produces edema. Gives a “pigskin” or orange peel look. Suggests cancer

Question 30

Fixation

Answer 30

Asymmetry, distortion, or decreased mobility with the elevated arm maneuver. As cancer becomes invasive, the fibrosis fixes the breast to the underlying muscle

Question 31

Deviation of nipple pointing

Answer 31

Cancer causing fibrosis in the mammary ducts which then pulls nipple angle towards it

Question 32

Gynecomastia

Answer 32

Benign enlargement of male breast that occurs when estrogen concentration exceeds testosterone levels. In older men it is bilateral whereas in adolescents it is usually unilateral

Question 33

Male breast cancer signs

Answer 33

Similar to those of a woman

Question 34

Benign “Fibrocystic” Breast Disease

Answer 34

Bilateral usually, Tender masses that occur with numerous symptoms like swelling, tenderness, mastalgia (severe pain), Nodularity (significant lumpiness), Dominant lumps, Nipple discharge, Infections and inflammations

Question 35

Breast Cancer signs

Answer 35

Solitary, unilateral, non-tender mass. Borders are irregular, Often painless, Unilateral, Found in women between the ages of 30-80

Question 36

Fibroadenoma

Answer 36

Benign tumors, most commonly present as self-detected in late adolescents.
Solitary non-tender mass that is solid, firm, rubbery, and elastic. Usually no axillary lymphadenopathy

Question 37

Fibroadenoma: common age it occurs

Answer 37

15 - 30 yrs, occurs up to 55

Question 38

Benign Breast Disease: common age it occurs

Answer 38

30 - 55, decreases after menopause

Question 39

Cancer: common age it occurs

Answer 39

30 - 80 yrs, risk increases after 50