Module 8: Breast Disorders/Reproductive CXR Flashcards
Breast anatomy
Tissues:
Glandular /lobules (milk)
Fatty
Connective/fibrous
Anatomy:
Lobes (15-20)
Lobules (small sections of tissue)
Nipple/areolae
Blood vessels, lymph vessels, nerves (immune system)
What is Mastalgia?
It is defined as breast pain and there are two kinds:
•cyclic mastalgia is associated with menstrual cycle.
Tx: compression, ice, analgesics & anti-inflammatory meds
•non-cyclic mastalgia is NOT related to menstrual cycle
Dx: diagnostics done if lump is found upon examination
Benign breast disorder: fibrocystic
know all info on this slide for test
•Most common breast disorder
•can occur in one or both breasts
•Frequently seen in women between ages 30-50
•May be due to heighted response of estrogen & progesterone (may become worse when on period)
•Pain d/t inflammation, edema & fibrosis
•Palpable lumps are round, well delineated, moveable*
•Usually increased in size before menstruation
•Not associated with increased cancer risk*
•Mammogram or biopsy
How to do a self-Breast exam
•3-5 days after period
•In front of mirror
•raising hands
•in the shower & laying down
•use pads of fingertips
•motions: top & bottom, circles, wedges
Benign Disorders- Fibroadenoma
•usually single lump on one side
•Benign tumor of the breast
•Most common in women under age
30
•May be causes by increased estrogen sensitivity
•Firm, painless, rubbery, easily moveable under skin (distinguishing factors)
•Slow growing (may increase in size in pregnancy)
•Mammogram and ultrasound
•Biopsy or removal
•Cryoablation or radiofrequency ablation
Benign Breast Disorders- Intraductal Papilloma
Benign tumor that grows in the mammary duct
•Usually unilateral*
•Occurs most often in women ages 30-50
•Can cause clear to bloody discharge* (distinguishing factor)
DX:
•Mammogram and ultrasound
•Needle biopsy
•Duct removal
Benign Breast Disorder- benign Ductal Ectasia
One or more milk duct widens, walls of the duct thicken, & the duct may fill with fluid, becoming clogged
•Occurs in perimenopausal women (before or around menopause)
•Nipple discharge common
•Other signs:
•Swelling, redness, & tenderness around nipple & areola (burning/itching type pain/inflammatory signs)
•Inverted nipple
•May lead to infection (removal of infected duct, antibiotics, warm compress)
Benign Breast Disorder- Male Gynecomastia
Noninflammatory enlargement of 1 or both breasts in males (imbalance of estrogen/testosterone)
•Usually temporary
•Can occur in puberty or older age
•Can be a manifestation of another problem or drug use
•Tumors, hyperthyroidism, liver disease, malnutrition
•Steroid use, marijuana, spironolactone can cause this disorder
Gero natural aging occurrences (breasts)
Pendulous breasts (low hanging/sagging)
•Loss of subcutaneous fat
•Loss of structural support
•Atrophy of mammary glands
•Decreased tissue density
•Increased incidence of breast cancer
•Encourage annual mammogram
•Mastopexy (breast lift surgery)
What are the 6 Benign Breast Disorders in this module?
•Mastalgia
•Fibrocystic Breast
•Fibroadenoma
•Benign Ductal Ecstasia
•Intraductal Papilloma
•Gynecomastia
•Table 51.1 common benign disorders
Warning signs of Breast cancer (what you see visually?)
•change in breast size or shape
•Lump, hard knot or thickening inside the breast or underarm area
•Swelling, Warmth, redness, or darkening of the breast
•dimpling or puckering of the skin (attach or pulling structures inward)
Warning signs of Breast Cancer (what to they feel?)
•New pain in one spot that doesn’t go away
•Nipple discharge that starts suddenly
•itchy, scaly sore, or rash on the nipple
•Pulling in of your nipple or other parts of the breast
Breast Cancer Screening Guideline
•Age 40 should have the opportunity to begin screening if wanted
•Age 45 should begin yearly mammograms
•Age 55 Transition to every other year
•Age 55+ continue to have regular mammograms
What is Mammography?
•Test of choice for screening to find disorders/suspicious findings
•Digital or 3D mammography
•Screening = pictures
•Diagnostic Mammogram = more pictures/in-depth to look at abnormal findings
•Ultrasound can see more structure
Breast Density & screening
Breasts that are more dense are harder to detect cancer in. It’s harder to see on the screening
What are the screening Barriers?
•Pain & embarrassment
•Fear of a cancer diagnosis
•Lack of health insurance
•Lack of knowledge about screening
•Lack of trust in doctors or hospitals
•Language barriers
•No transportation
What are the risk factors for Breast Cancer?
Hereditary:
•Being born female
•Age (50-60’s menopausal)
•Race & Ethnicity
•Inheriting certain genes (BRCA 1&2)
•Family History of breast cancer
•Personal history of breast cancer
Lifestyle Factors:
•Drinking alcohol
•Being overweight or obese (excess circulation of estrogen stores in fat tissue)
•Not being physically active
•Smoking
Hormone Related:
•Not having children or breastfeeding (increases life span of hormones -not stopping cycle because of pregnancy)
•Birth Control
•Hormone therapy after menopause
What are BRCA Mutations?
“BRCA mutations contribute to cancer”
•Oncogenes increase cell division & growth
•Tumor Suppressor cells make division stop.
(In Cancer one of these things is broken)
The BRCA gene creates a protein that fixes double stranded breaks in DNA. The protein that repairs DNA damage changes shape and is non-functional. This can increase cancer risk.
How to minimize cancer risks
•Maintain a healthy weight
•Physical activity
•Avoid or limit alcohol
•Smoking cessation
•Routine self-examination, MD visits, and yearly mammograms
•Genetic testing & counseling
•Preventative surgery for those at very high risk
Breast CXR in males
•1 in 1,000 men will be diagnosed with breast cancer
•May form in the ducts or lobes
•Risk factors: increased estrogen, family history, radiation exposure
Breast CXR in males s/s
•Men in BRCA-positive families should consider genetic testing
•Signs & Symptoms:
•Painless lump or thickening of breast tissue
•Changes to the skin and nipple
•Discharge
Diagnostics for Breast CXR
•Mammography
•Ultrasound (Distinguishes fluid vs. solid)
•Biopsy
•Fine needle aspiration
•Core needle biopsy (hollow needle, takes cells out)
•Surgical biopsy
•Lymph node biopsy
•MRI
What is sentinel lymph node Biopsy
They take the closest lymph node to the issue of possible cancer
Types of Breast CXR
Ductal carcinoma is 80% of invasive CXR
“Best” place to get CXR is ‘in situ’ because it means it hasn’t spread.
•ductal breast CXR
•Mixed tumor breast CXR
•Inflammatory breast CXR (fast growing, high risk, often mistaken for an infection. When not responding to antibiotics this is investigated)
•lobular Breast CXR
