Exam 2 - Breast exams

Question 1

Are self breast exams recommended?

Answer 1

No, but breast awareness suggested

Question 2

Are clinical breast exams recommended?

Answer 2

No (insufficient evidence)

• Being able to distinguish a cyst from a solid mass requires further evaluation
• Can be helpful to determine whether mass is discrete or just thickening of breast tissue

Question 3

At what age range are simple cysts most commonly found in women?

Answer 3

Ages 40-49 years

Question 4

What are the four diagnostic tests that can be used for breast cancer?

Answer 4

• Ultrasound
• Cyst aspiration
• Fine needle aspiration
• Core needle biopsy

Question 5

How can ultrasonography be useful for young women?

Answer 5

Helps differentiate between solid mass and fluid filled cysts when performing guided needle biopsy

Question 6

Can ultrasonography be used in conjunction with mammography?

Answer 6

Yes

Question 7

What are the benefits of using ultrasonography in diagnosing breast cancer?

Answer 7

Useful in women with dense breasts who are <30 years old

• Can be the only test needed if cysts are confirmed

Question 8

How is cyst aspiration helpful in diagnosing breast cancer?

Answer 8

Helps distinguish between malignant or benign mass

Question 9

What should the provider do if no blood/pus is noted, or collapse of cyst occurs, during cyst aspiration?

Answer 9

Follow up in 3 months to make sure there is no residual mass palpable or reaccumulation of fluid

Question 10

How are fine needle aspirations helpful in diagnosing breast cancer?

Answer 10

Can detect solid masses

Question 11

Which diagnostic modality is the least invasive in diagnosing breast cancer?

Answer 11

Fine needle aspiration

Question 12

How are core needle biopsies helpful in diagnosing breast cancer?

Answer 12

Are used when fine needle aspiration is not available

• Can diagnose between invasive or non-invasive cancer
• Can sample non-palpable masses

Question 13

What is a complication that can occur with core needle biopsy?

Answer 13

Uses a larger gauge needle –> lung perforation

Question 14

What should the provider do if a solid breast mass is detected?

Answer 14

Follow up with mammography

Question 15

What should the provider do if findings are normal?

Answer 15

Follow up in 3-6 months

• Refer to breast clinic for severe cases

Question 16

Is mammography a screening or diagnostic tool?

Answer 16

Screening

• Can be diagnostic when a more comprehensive exam of identified breast abnormality is needed

Question 17

Can mammography differentiate between malignant, benign, or cystic lesions?

Answer 17

No

Question 18

When are mammographies required?

Answer 18

Performed in asymptomatic women to help identify invasive breast cancer at an early, curable age (when treatment will be most effective)

Question 19

What are the two views seen on mammography?

Answer 19

Craniocaudal and mediolateral

Question 20

What is digital breast tomosynthesis?

Answer 20

3D images taken from mammogram

• Associated with fewer recall rates
• Reduced patient anxiety and radiation exposure

Question 21

When would the provider order an MRI?

Answer 21

Reserved for patients with high risk or positive BRCA gene