Disorders of the Breast

Question 1

disorders of the breast we need to know (4)

Answer 1

abscess
fibroadenoma
fibrocystic changes
mastitis

Question 2

32 yo lactating f w. breast pain, swelling, f/c, and fluctuant mass in left breast - area above lesion is warm, erythematous, and ttp

Answer 2

breast abscess

Question 3

t/f: women w. breast abscess should continue to breastfeed on affected side even in setting of I&D

Answer 3

t!

*she can use hand expression or breast pumping if procedure interferes w. ability to breastfeed *

Question 4

a breast abscess is a pocket of infection contained w.in the breast that is often a complication of

Answer 4

mastitis

Question 5

what differentiates mastitis from a breast abscess (2)

Answer 5

w. breast abscess:
localized mass
signs of infxn

Question 6

mc pathogen assocaited w. breast abscess

Answer 6

s. aureus

Question 7

tx for breast abscess

Answer 7

-I&D
-nafcillin/oxacillin IV OR cefazolin PLUS metro
-alt: vanco
-continue bf

Question 8

27 yo f w. painless mass in r breast x 3 months - it has not changed in size - lmp 10 days ago - no fam hx breast ca - PE shows 3 cm, firm, non tender, smooth, well circumscribed, mobile mass in ULQ - no skin changes, nipple d.c, or axillary LAD

Answer 8

breast fibroadenoma

Question 9

what is this US showing

Answer 9

breast fibroadenoma

Question 10

mc type of noncancerous breast tumor

Answer 10

fibroadenoma

Question 11

fibroadenomas mc affect what age group

Answer 11

young women

Question 12

describe a fibroadenoma (7)

Answer 12

solitary
small
mobile
firm
painless
well circumscribed
completely round

Question 13

classic description of fibroadenoma

Answer 13

rubbery

Question 14

t/f: size of fibroadenoma may was and wane w. menstruation

Answer 14

t!

Question 15

t/f: fibroadenomas may become painful for a few days before onset of menstruation

Answer 15

t!

Question 16

dx for fibroadenoma

Answer 16

mammogram
US
fine-need aspiration
+/- bx

Question 17

indication for bx of fibroadenoma

Answer 17

< 25 yo

Question 18

tx for fibroadenoma (3)

Answer 18

supportive bra
combined OCP
avoid caffeine/chocolate

Question 19

42 yo f w. breast masses that change in size, esp during menstrual cycles - masses are painful, pain radiates to axillae - c/o full/heavy feeling in breasts - small, occassional greenish-brown nipple d.c

Answer 19

fibrocystic dz

Question 20

describe fibrocystic dz masses (7)

Answer 20

multiple
bilateral
well circumscribed
round
discrete
somewhat mobile
increase in size and pain before menses

Question 21

what relieves pain of fibrocystic breast changes

Answer 21

onset of menses

Question 22

dx of fibrocystic changes (3)

Answer 22

fine needle aspiration
US
+/- mammogram

Question 23

fine need aspiration findings of fibrocystic changes

Answer 23

straw-colored fluid w. NO blood

Question 24

tx for fibrocystic changes (5)

Answer 24

NSAIDs
heat/ice
supportive bra
avoid caffeine/chocolate/fatty foods
OCP

Question 25

if women w. fibrocystic changes want to do self breast exam, when should they do it

Answer 25

one week after period

when cysts are smallest

Question 26

t/f: fibrocystic changes mc self resolve

Answer 26

t!

Question 27

breastfeeding f 3 weeks postpartum c/o painful area of breast that is red/warm - she feels fatigued and is febrile -

Answer 27

mastitis

Question 28

describe mastitis pain

Answer 28

burning
constant vs only when breastfeeding

Question 29

PE findings of mastitis (4)

Answer 29

unilateral erythematous breast
palpable mass
induration
ttp

Question 30

what do you think when you see: primigravida pt w. bilateral, painful breast engorgement

Answer 30

congestive mastitis

Question 31

mc pathogen associated w. breast infxns

Answer 31

s. aureus

Question 32

regional infxn of the breast from skin flora/oral flora of breastfeeding baby -> oragnism enters erosion or cracked nipple

Answer 32

mastitis

Question 33

mc cause of mastitis

Answer 33

clogged milk ducts

Question 34

mastitis is mc caused by _ trauma

Answer 34

nipple

Question 35

congestive mastitis is _ lateral
infectious mastitis is _ lateral

Answer 35

congestive: bilateral
infectious: unilateral

Question 36

dx for mastitis

Answer 36

clinical
+/- US

Question 37

tx for mastitis

Answer 37

warm compress 4x/day
analgesics
abx if infectious
continue to bf

Question 38

abx for infectious mastitis (3)

Answer 38

dicloxacillin
cephalexin
erythromycin