Normal and Abnormal Breast Flashcards
1
Q
estrogen and progesterone- fxn
A
- estrogen- growth of adipose tissue and lactiferous ducts
- progesterone- stim of lobular growth and alveolar budding
2
Q
evaluation of breast sx’s
A
- timely evaluation
- breast pain and mass- 2 most common
- pt hx
3
Q
risk factors for breast cancer
A
- age
- hx of breast cancer
- hx of atypical hyperplasia
- high breast tissue density
- first degree relatives with breast or ovarian cancer
- early menarche (<12)
- late cessation of menses (>55)
- no term pregnancies
- never breastfed
- long-term use of oral contraceptives
4
Q
Diagnostic testing
A
- mammogram
- US
- MRI
- FNA
- core bx
5
Q
palpable masses- get what?
A
biopsy
6
Q
mammography
A
detect lesions 2 yrs b/f they become palpable
- best in women 40 yo or older
- screening
- diagnostic
7
Q
breast cancer screening guidelines
A
(ACOG)
- mammo- 40 yo+ annually
- clinical exam- age 20-39: 1-3 yrs; age 40+: annually
- self-breast exam
8
Q
Ultrasonography
A
- evaluate inconclusive mammogram findings!!
- women < 40 yo and those with dense breast tissue
- cystic vs solid lesions
- guidance for core needle biopsies
9
Q
MRI
A
- adjunct to diagnostic mammography
- post cancer dx for further evaluation
- used with implants
- women at high risk (BRCA)
10
Q
Fine Needle Aspiration Biopsy
A
solid vs cystic!!
- clear fluid- needs no further evaluation
- bloody fluid- sent for cytology, pt needs mammogram/US
- if cyst completely disappears with aspiration- return in 3 months for clinical breast exam
- if cyst reappears or does not resolve- mammogram/US and perform bx
11
Q
Core Needle Biopsy
A
- large needle
- larger solid masses for dx
12
Q
Mastalgia
A
- cyclic (starts at luteal phase to menses)
- noncyclic- tumors, mastitis, cysts, meds
- extramammary- chest wall trauma, shingles, fibromyalgia
13
Q
Mastalgia- tx
A
-Danazol- but horrible SE’s (not ever prescribed)
-oral contraceptives or Depo Provera may help
properly fitting bra, weight reduction, exercise, dec caffeine intake, vit E supplementation
14
Q
nipple discharge
A
- usually benign
- could be endocrine disorder or cancer
- b/l, non-spontaneous, non bloody- fibrocystic changes or ductal eectasia
15
Q
Bloody nipple discharge
A
- considered cancer till proven otherwise!!!
- concern for intraductal carcinoma or invasive ductal carcinoma
- benign intraductal papilloma
- evaluated with breast ductography- requires ductal excision
