Disorders of the Breast Flashcards

1
Q

disorders of the breast we need to know (4)

A

abscess
fibroadenoma
fibrocystic changes
mastitis

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2
Q

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

A

breast abscess

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3
Q

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

A

t!

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

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4
Q

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

A

mastitis

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5
Q

what differentiates mastitis from a breast abscess (2)

A

w. breast abscess:
localized mass
signs of infxn

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6
Q

mc pathogen assocaited w. breast abscess

A

s. aureus

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7
Q

tx for breast abscess

A

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

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8
Q

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

A

breast fibroadenoma

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9
Q

what is this US showing

A

breast fibroadenoma

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10
Q

mc type of noncancerous breast tumor

A

fibroadenoma

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11
Q

fibroadenomas mc affect what age group

A

young women

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12
Q

describe a fibroadenoma (7)

A

solitary
small
mobile
firm
painless
well circumscribed
completely round

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13
Q

classic description of fibroadenoma

A

rubbery

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14
Q

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

A

t!

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15
Q

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

A

t!

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16
Q

dx for fibroadenoma

A

mammogram
US
fine-need aspiration
+/- bx

17
Q

indication for bx of fibroadenoma

18
Q

tx for fibroadenoma (3)

A

supportive bra
combined OCP
avoid caffeine/chocolate

19
Q

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

A

fibrocystic dz

20
Q

describe fibrocystic dz masses (7)

A

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

21
Q

what relieves pain of fibrocystic breast changes

A

onset of menses

22
Q

dx of fibrocystic changes (3)

A

fine needle aspiration
US
+/- mammogram

23
Q

fine need aspiration findings of fibrocystic changes

A

straw-colored fluid w. NO blood

24
Q

tx for fibrocystic changes (5)

A

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

25
if women w. fibrocystic changes want to do self breast exam, when should they do it
one week after period *when cysts are smallest*
26
t/f: fibrocystic changes mc self resolve
t!
27
breastfeeding f 3 weeks postpartum c/o painful area of breast that is red/warm - she feels fatigued and is febrile -
mastitis
28
describe mastitis pain
burning constant vs only when breastfeeding
29
PE findings of mastitis (4)
unilateral erythematous breast palpable mass induration ttp
30
what do you think when you see: primigravida pt w. bilateral, painful breast engorgement
congestive mastitis
31
mc pathogen associated w. breast infxns
s. aureus
32
regional infxn of the breast from skin flora/oral flora of breastfeeding baby -> oragnism enters erosion or cracked nipple
mastitis
33
mc cause of mastitis
clogged milk ducts
34
mastitis is mc caused by _ trauma
nipple
35
congestive mastitis is _ lateral infectious mastitis is _ lateral
congestive: bilateral infectious: unilateral
36
dx for mastitis
clinical +/- US
37
tx for mastitis
warm compress 4x/day analgesics abx if infectious continue to bf
38
abx for infectious mastitis (3)
dicloxacillin cephalexin erythromycin