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ENRP > Normal and Abnormal Breast > Flashcards

Normal and Abnormal Breast Flashcards

1
Q

What is the normal breast composed of?

A

Glands
Ducts
Fat and CT

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2
Q

There are 12-20 lobes in the normal breast, with greater amount of glandular tissue where?

A

UOQ

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3
Q

The normal breast is rich in blood supply and lymphatics. What 2 lymph nodes are common routes of metastasis?

A

Ipsilateral LN

Internal Mammatory LN

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4
Q

What causes growth of fat tissue and ducts in the breast?

A

Estrogen

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5
Q

What causes growth of lobes and alveolar budding in the breast?

A

Progesterone

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6
Q

What are 4 congenital anomalies of the breast?

A
  1. Absence of breast
  2. Accessory breast tissue along milk line
  3. Extra nipples
  4. Extra breasts
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7
Q

Polythelia

A

Extra nipples

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8
Q

Polymastia

A

Accessory breasts

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9
Q

What are the 2 most common complaints of the breast?

A

Pain

Mass

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10
Q

Breast complaints need a ____ evaluation

A

TIMELY

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11
Q

List as many risk factors for breast cancer as you can

A 
Age
Early menarche (<12)
Late cessation of menses (>55) and post-menopause obesity 
NO pregnancies
Use of oral contraceptives
Tall
High breast tissue density 
1st degree relatives with breast/ovarian cancer
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12
Q

List as many risk factors for breast cancer as you can

A 
Age
Early menarche (<12)
Late cessation of menses (>55) and post-menopausal obesity
Oral contraceptive use
NO pregnancies
High breast tissue density
Tall
1st degree relatives with breast/ovarian cancer
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13
Q

What should be evaluated in the breast physical exam?

A

BOTH breasts + axilla + chest wall

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14
Q

Palpable breast masses will always get?

A

BIOPSY

- core needle/fine needle aspiration/excision

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15
Q

In what patients is mammography best?

A

Women > 40

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16
Q

Women > 40 should get what diagnostic test?

A

Mammography

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17
Q

Mammography can detect?

A

Lesion 2 years before its palpable

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18
Q

In what patients is ultrasound best?

A

Women < 40

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19
Q

Women < 40 years old should get what diagnostic test?

A

Ultrasound

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20
Q

Women with dense breast tissue should get what test?

A

Ultrasound

21
Q

What can Ultrasound differentiate between?

A

Cystic and solid lesions

22
Q

When is MRI used?

A

Post-cancer diagnosis evaluation

Women with high risk for breast cancer – BRCA (+)

23
Q

What does a Fine Needle Aspiration biopsy determine? What size needle?

A

Solid vs. cystic mass

SMALL needle

24
Q

If a Fine Needle Aspiration biopsy pulls clear fluid, next step?

A

NO further evaluation

25
Q

If a Fine Needle Aspiration biopsy pulls bloody fluid or if the cyst reappears, then what?

A

Need mammogram/ultrasound and tissue biopsy

26
Q

What does a Core Needle Biopsy get? Needle size?

A

Gets tissue from larger solid masses

LARGE needle

27
Q

Mastalgia

A

Breast pain

28
Q

2 types of Mastalgia?

A

Cyclic

Noncyclic

29
Q

Cyclic Mastalgia

A

Starts at luteal phase and ends after onset of menses

30
Q

Noncyclic Mastalgia

A

Can be caused by medications, tumors, cysts, mastitis

31
Q

What is the only FDA approved medication for Mastalgia, although it has many unpleasant side effects?

A

Danazol

32
Q

What are the non- medication options for Mastalgia?

A
  • Properly fitting bra
  • Exercise
  • Decrease weight, caffeine
  • Vitamin E supplementation
  • Evening primrose oil
33
Q

What are the non-medication options for Mastalgia?

A
  • Properly fitting bra
  • Exercise
  • Decrease weight, caffeine
  • Vitamin E supplementation
  • Evening primrose oil
34
Q

Nipple discharge - usually benign or malignant?

A

Benign

35
Q

If nipple discharge is bloody it is?

A

Considered cancer until proven otherwise

36
Q

How is bloody nipple discharge evaluated?

A

Breast ductography and requires ductal excision

37
Q

Nipple discharge is usually benign but when is it considered cancer?

A

BLOOD

38
Q

What are some characteristics of malignant breast masses?

A
  • Size > 2cm
  • Immobile, firm, poor margins
  • Skin dimpling and color changes
  • Ipsilateral LAD
39
Q

3 types of Benign breast masses?

A
  1. Non-proliferative
  2. Proliferative without atypia
  3. Proliferative with atypia
40
Q

Proliferative with atypia breast masses are what?

A

Malignant cells replace normal ductal/lobular epithelium

– “carcinoma in situ”

41
Q

How should proliferative with atypia breast masses be treated?

A

Excision and SERM

42
Q

Breast cancer is the most common malignancy in women besides what?

A

Skin cancer

– second leading cause of cancer related deaths

43
Q

What age and race are at an increased risk for breast cancer?

A

> 50

white

44
Q

List the common types of breast cancer to the least common

A

Ductal –> LN spread
Lobular – multifocal
Nipple
Inflammatory

45
Q

What can be used to guide breast cancer treatment?

A

Receptor status

46
Q

What are positive findings with breast cancer?

A

Estrogen and progesterone

47
Q

Presence of what oncogene signifies a worse prognosis of breast cancer?

A

Her2/neu

48
Q

Surgical options can be considered with breast cancer. How do the 2 options compare to each other?

A

Mastectomy = Lumpectomy with radiation

- equal outcomes

49
Q

How does a mastectomy compare to a lumpectomy with radiation?

A

EQUAL

ENRP (45 decks)

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