Clinical Breast - Onello

Question 1

What is polymastia?

Answer 1

an extra breast

Question 2

WHat is polythelia?

Answer 2

an extra nipple

Question 3

What is Amastia?

Answer 3

the abscence of breast and nipple - possibly even the pectoralis muscle

Question 4

Why do newborns have breast tissue?

Answer 4

in reaction to mom’s hormones during pregnancy

Question 5

What is the average age of thelarche?

Answer 5

12 (12.1 in african americans, 12.5 in caucasians)

Question 6

What is the amount of time between thelarche and onset of menarche?

Answer 6

typically about 2 - 2.5 years

Question 7

Is it normal for adolescent breast development to occur asymmetrically?

Answer 7

yes

Question 8

In a pubertal male, can gynecomastia be normal?

Answer 8

yes - usually resolves on its own

especially if it’s an isolated finding in the context of other normal development

Question 9

What are some less common causes of gynecomastia that are now physiological?

Answer 9

Kleinfelter syndrome
testicular feminization
hormone secreting tumor
hyper or hypothyroid
cirrhosis
drug use - cimetidine
familial predisposition
obesity

Question 10

What percentage of american women initiate breastfeeding?

Answer 10

83% in 2002

Question 11

Initiation is higher in what groups?

Answer 11

wealthier
more educated
caucasian
non-smokers

Question 12

How long do women in the United States typically breastfeed?

Answer 12

depends on who you talk to

6 months- 12 months

but the WHO pushes for 2 years

Question 13

What percentage of women are still breast feeding exclusively at 4 months?

Answer 13

only 35%

Question 14

There ar elots of reasons people stop breast feeding. Many will say they didn’t have enough milk, but what percentage is this actually true in?

Answer 14

only 1-5%

Question 15

True or false; breastfeeding is largely an innate act for us.

Answer 15

false - it’s a social behavior that we have to learn

Question 16

Why is alternating the use of formula and breast maybe not help breast feeding overall?

Answer 16

milk production will go down if you don’t breast feed frequently

also, the baby finds it easier to drink out of a bottle and may not want to go back to the breast

Question 17

True or false: Your familial risk for beast cancer is equal whether it’s on your dad’s side or mom’s side?

Answer 17

false - really only if it’s on the maternal side

Question 18

What are some worrisome findings on breast exams?

Answer 18

lump or contour change
skin tethering
nipple inversion
ulceration
nipple scaling
edema or peua d'orange

Question 19

Why is mammogram the current standard for diagnosing breast cancer?

Answer 19

it can pick up a cancer when it’s too small to pick up on clinical exam

Question 20

True or false - you don’t do mammogams if someone has a breast implant.

Answer 20

false - you still do them

it can be harder to see, but you still need to do them

Question 21

What proportion of people with breast cancer have no identifiable risks?

Answer 21

3/4!

Question 22

When can US be helpful when evaluating the breast?

Answer 22

it can help determine if a mass if cystic or solid - not helpful for screening

Question 23

What are some risk factors for breast cacner?

Answer 23

advanced age
northern european descent
early menses, late menopause
obesity
nulliparity/delayed first child
high fat diet
hx of endometrial or ovarian cancer
CA in mom, aunt, sister

Question 24

What is the average american woman risk for development breast cancer in her life?

Answer 24

12.15%

Question 25

What are some general causes of masses?

Answer 25

fibroadenoma
cystosarcoma phylloides
abscess
cyst
trauma/hematoma
malignancy
sebaceous cysts
lipomas
hamartomas
fat necrosis
galactocele

Question 26

What are some things that can cause breast discharge?

Answer 26

mammary duct ectasia - thick grey to black

intraductal papilloma - serous and maybe bloody

Question 27

What are some options for biopsies in this area?

Answer 27

fine needle aspiration
core needle biopsy
excisional biopsy
incisional biopsy

Question 28

What are some reasons the fine needle aspirations aren’t used as often anymore?

Answer 28

it’s less accurate becaus eyou don’t get much tissue

plus it has to be an obvious palpable lesion