Clinical Breast - Onello Flashcards
What is polymastia?
an extra breast
WHat is polythelia?
an extra nipple
What is Amastia?
the abscence of breast and nipple - possibly even the pectoralis muscle
Why do newborns have breast tissue?
in reaction to mom’s hormones during pregnancy
What is the average age of thelarche?
12 (12.1 in african americans, 12.5 in caucasians)
What is the amount of time between thelarche and onset of menarche?
typically about 2 - 2.5 years
Is it normal for adolescent breast development to occur asymmetrically?
yes
In a pubertal male, can gynecomastia be normal?
yes - usually resolves on its own
especially if it’s an isolated finding in the context of other normal development
What are some less common causes of gynecomastia that are now physiological?
Kleinfelter syndrome testicular feminization hormone secreting tumor hyper or hypothyroid cirrhosis drug use - cimetidine familial predisposition obesity
What percentage of american women initiate breastfeeding?
83% in 2002
Initiation is higher in what groups?
wealthier
more educated
caucasian
non-smokers
How long do women in the United States typically breastfeed?
depends on who you talk to
6 months- 12 months
but the WHO pushes for 2 years
What percentage of women are still breast feeding exclusively at 4 months?
only 35%
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?
only 1-5%
True or false; breastfeeding is largely an innate act for us.
false - it’s a social behavior that we have to learn
Why is alternating the use of formula and breast maybe not help breast feeding overall?
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
True or false: Your familial risk for beast cancer is equal whether it’s on your dad’s side or mom’s side?
false - really only if it’s on the maternal side
What are some worrisome findings on breast exams?
lump or contour change skin tethering nipple inversion ulceration nipple scaling edema or peua d'orange
Why is mammogram the current standard for diagnosing breast cancer?
it can pick up a cancer when it’s too small to pick up on clinical exam
True or false - you don’t do mammogams if someone has a breast implant.
false - you still do them
it can be harder to see, but you still need to do them
What proportion of people with breast cancer have no identifiable risks?
3/4!
When can US be helpful when evaluating the breast?
it can help determine if a mass if cystic or solid - not helpful for screening
What are some risk factors for breast cacner?
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
What is the average american woman risk for development breast cancer in her life?
12.15%
What are some general causes of masses?
fibroadenoma cystosarcoma phylloides abscess cyst trauma/hematoma malignancy sebaceous cysts lipomas hamartomas fat necrosis galactocele
What are some things that can cause breast discharge?
mammary duct ectasia - thick grey to black
intraductal papilloma - serous and maybe bloody
What are some options for biopsies in this area?
fine needle aspiration
core needle biopsy
excisional biopsy
incisional biopsy
What are some reasons the fine needle aspirations aren’t used as often anymore?
it’s less accurate becaus eyou don’t get much tissue
plus it has to be an obvious palpable lesion
