Disorders of the Breast

Question 1

What are the greatest risk factors for developing breast cancer?

Answer 1

age and gender

Question 2

What is the appearance of Pagets disease?

Answer 2

malignant condition of breast that has appearance of eczema

Question 3

what are fibroadenomas?

Answer 3

common benign, solid tumors, and are usually firm, painless and freely mobile

Question 4

How are accurate prolactin levels obtained?

Answer 4

fasting state after no breast stimulation for 24 hours

Question 5

What would you do if pt had elevated prolactin with white breast discharge after quitting breastfeeding 6 months ago?

Answer 5

brain MRI to rule out pituitary tumor

Question 6

How can you medically manage pituitary microadenoma in setting of elevated prolactin and white breast discharge?

Answer 6

bromocriptine treatment

Question 7

How long can postpartum women produce milk after breastfeeding?

Answer 7

2 years

Question 8

What study is indicated if patient has bloody discharge from a single breast duct?

Answer 8

ductogram

Question 9

What are fibrocystic breast changes?

Answer 9

most common type of benign breast condition and occur most during reproductive years; fibrocystic disease is often associated with cyclic mastalgia, possibly related to pronounced hormonal response; caffeine intake can increase the pain

Question 10

If FNA is done on breast mass and returns clear fluid and mass resolves, what do you do for followup?

Answer 10

reexamine in 2 months to see if cyst resolved

Question 11

What do you do if breast mass FNA produces bloody fluid in addition to mammogram?

Answer 11

excisional biopsy; normal mammogram does not rule out breast cancer, especially in setting of bloody dishcarge

Question 12

When does lactational mastitis most often occur and how does it present?

Answer 12

during first 3 months of breastfeeding; firm, red, painful area of one breast often associated with fever

Question 13

how do you manage lactational mastitis?

Answer 13

ibuprofen and cold compresses for pain relief, continue breastfeeding, oral antibiotics(most often caused by S. aureus)

Question 14

what can a breast ultrasound do?

Answer 14

distinguish between a cyst and a solid mass

Question 15

When is breast MRI indicated in addition to mammography?

Answer 15

may be indicated in patients with increased risk of breast cancer: BRCA mutation carriers, first degree relatives of BRCA carriers, genetic mutations such as Li Fraumeni, women with 20-25% risk of lifetime breast cancer, or women with history of radiation to chest between 10 and 30 years old