Chapter 19: Breast Flashcards
A 45 yo woman comes to clinic b/c of severe pain and swelling behind her right nipple-areolar complex. She relates a hx of previous episode that she treated w/ warm compresses until it resolved w/ a thick, yellow d/c from the nipple. She has no FH of breast cancer. She has a 25yr hx of smoking. PE reveals a painful, distorted, partially retracted nipple w/ a yellow d/c. Definitive therapy requires:
Antibiotics followed by excision of the subareolar ducts and fistula tract
A 22 yo woman comes to the clinic b/c of right breast mass. She is nulliparous. Menarche was a age 13. There is no FH of breast cancer. She is otherwise healthy and takes no meds. There is a 1.5 cm firm, non-tender, mobile mass palpable in the UOQ of the right breast. Rest of her exam is completely normal. U/S shows an ovoid solid mass measuring 1.5 cm w/ smooth borders. Needle bx shows cells consistent w/ fibroadenoma. What is the next step in management?
Observation
A 29 yo woman comes to clinic b/c of 5w hx of right breast mass that she noted on self-exam. She has no significant factors for the development of breast cancer. On exam there is an area of increased density versus a mass in the UOQ of the right breast. The rest of the exam is unremarkable. The most appropriate next step would be:
Breast ultrasound
A 32 yo woman comes to clinic b/c of mass in her left breast. She is 6mo pregnant and has very large breasts. Her mother had BC at age 62. There is a 3.5cm hard, irregular mass in left breast. A 2.5cm mobile mass is palpable in the left axilla. Both the breast and axilla yr masses show malignant cells on FNA cytology. Which of these factors is a contraindication to lumpectomy?
Pregnancy
A 44 yo woman comes to clinic b/c of red skin on the right breast for 10 days. Her last menstrual period was 3 weeks ago and her menarche was age 12. Her first child was born at age 25 and she has had no previous breast problems. She has no FH of breast cancer and no hx of any major medical illnesses. On PE, the skin over the RUO breast is red and edematous w/ minimal tenderness. There are no masses, no nipple d/c or axillary lymphadenopathy. Bx of skin shows breast cancer cells. Which of the following is the stage classification for this BC?
Stage III
A 60 yo woman comes to clinic following partial mastectomy and sentinel LN bx for stage 1 infiltrating ductal carcinoma of right breast. She had menarche at age 14 and menopause at age 53. She has had no previous breast problems and no FH of breast cancer. She has HTN tx w/a B. Arimadex therapy is planned. Which of the following is the best way to follow this pt during the next 3 years?
History and physical examination every six months, annual mammogram
A 43yo woman is seen in clinic 2w following a partial mastectomy and sentinel LN bx for a 1.8cm invasive ductal adenocarcinoma of the left breast. She is complaining of numbness and tingling on the posterior aspect of her upper left arm. She has no muscle w/n in the left upper extremity and has full ROM in her left shoulder. There is no swelling or edema. The surgical incisions are healing well. Injury to which of the following is the most likely explanation of her sxs?
Intercostal brachial nerve
A 25yo woman comes to clinic b/c of a 2 week hx of tender lump in her right breast. Her last menstrual period was 3w ago. PE reveals discrete 2.5cm mass in the UOQ of her right breast. U/s shows smooth, oval 2.5cm hypoechoic mass w/ no internal echoes. The next best step in management is to:
Aspirate the lesion
A 28yo woman comes to clinic b/c of breast pain. The pain started about 3mo ago and is cyclical and bilateral. Menarche was at age 11. She is nulliparous. She was recently started on OCPs b/c of heavy menstrual bleeding. Her paternal grandmother died of endometrial cancer, and her mother and maternal grandmother both had BC in their 40s, but are alive and well. She has no other complaints and no medical problems. Her exam does not reveal any suspicious findings. Which of the following elements of her hx places her at greatest risk for BC?
Family history of breast cancer
A 60 yo woman is being seen in clinic following excision of ICIS of her left breast. Radiation therapy to the breast has been recommended and she wants to know if there are any possible problems related to radiation therapy. Which of the following is an adverse effect of whole breast radiation?
Fibrosis
