Promoting Breast Health

Question 1

Fibrocystic breast changes

Answer 1

Benign, occur in >50% of women, cause fear anxiety, risk factor for cancer

Question 2

Breast cancer

Answer 2

Malignant, early detection is key, most common cancer in women, 2nd leading cause of cancer death in women, chance of invasive disease 12%

Question 3

Breast anatomy

Answer 3

Composed of glands, fibers, fat, blood, lymph, lobes, lymph vessels drain in axillary nodes

Question 4

Breast health promotion

Answer 4

Cancer screening, nutrition, limited alcohol, no smoking, exercise, healthy weight

Question 5

Breast self-examination (BSE)

Answer 5

Self awareness, familiarity with breast contours, after menstrual period ends

Question 6

Clinical breast examination

Answer 6

At least once every 3 years, annually after age 40, early detection, opportunity to discuss breast awareness and BSE

Question 7

Mammogram

Answer 7

Early diagnosis after symptom or lump is found, screening in women with no symptoms, initiate at age 40

Question 8

Fibrocystic changes

Answer 8

Fluid filled sacs

Question 9

Fibroadenomas

Answer 9

Solid cysts composed of connective tissue and glandular tissue

Question 10

Lipomas

Answer 10

Fat tumors

Question 11

Intraductal papillomas

Answer 11

Wart like growths in milk ducts near nipple

Question 12

Mammary duct ectasia

Answer 12

Inflammation of ducts behind nipple

Question 13

Mastitis

Answer 13

Bacterial infection most commonly associated with breast feeding

Question 14

Trauma, injury

Answer 14

May result in hematoma or fat necrosis

Question 15

Evaluate abnormalities

Answer 15

Repeat CBC, mammogram, sonogram, MRI, needle aspiration (fluid filled sac), biopsy

Question 16

Breast biopsy

Answer 16

Fine needle aspiration (FNA), core needle biopsy, stereotactic biopsy (fine needle under X-ray), surgical (open), skin (punch)

Question 17

Hormone receptor testing

Answer 17

When estrogen and progesterone receptor proteins are located on cancer cells, binding promotes further growth, testing helps guide treatment, if involved the tumor will respond to hormone manipulation therapy

Question 18

Breast symptoms

Answer 18

Nipple discharge- galactorrhea (pregnancy, meds, tumor), bloody (intraductal papilloma, infection, cancer)
Skin changes-erythema, peau d’orange
Pain

Question 19

Risk factors

Answer 19

Women 100x more at risk, over age 55, smoking, alcohol, obesity, family history, +BRACA gene 1 and 2, lifelong exposure to estrogen, pregnancy after 30, early menarche, late menopause, precious diagnosis 3-4x more at risk

Question 20

Lifestyle related risk factors

Answer 20

Oral contraceptive, post menopausal combine hormone therapy, sedentary lifestyle, alcohol, smoking, weight

Question 21

Gene defects

Answer 21

Account for 5-10% of breast cancers, +BRACA 1 and 2

Question 22

Adenocarcinoma

Answer 22

Accounts for majority of breast cancers, arises from ducts and lobules, either situ or invasive, most are invasive

Question 23

Inflammatory breast cancer

Answer 23

Rare and aggressive, skin changes but no lumps, redness, itching, thickening, nipple retraction, swelling, pain, MRI to diagnose, metastasis often already present

Question 24

Prognosis indicators

Answer 24

Stage, type, rumor size, lymph node involvement, hormone receptor levels, presence of HER2/neu

Question 25

HER2 (human epidermal growth factor receptor 2)

Answer 25

Over expression is associated with increased disease progression and a worse prognosis

Question 26

Stage 0

Answer 26

Ductal carcinoma in situ, earliest form

Question 27

Stage 1

Answer 27

2 cm or less, no lymph nodes, no metastasis

Question 28

Stage 2

Answer 28

2 cm lesion

Question 29

Stage 3A

Answer 29

5 cm lesion with 1-9 axillary lymph nodes or mammary lymph node

Question 30

Stage 3B

Answer 30

Tumor has grown into chest wall and skin and no lymph node OR spread to 1-3 lymph nodes no mets OR 4-9 axillary lymph nodes or enlarge my of mammary lymph node

Question 31

Sage 3C

Answer 31

Sizable tumor with 10+ lymph nodes, above clavicle

Question 32

Stage 4

Answer 32

Spread to nodes and metastasis

Question 33

Surgery

Answer 33

Lumpectomy, partial mastectomy, simple mastectomy, modified radical mastectomy

Question 34

Adjunct treatment

Answer 34

Chemotherapy, radiation, hormone therapy

Question 35

Potential health issues

Answer 35

Infertility, menopausal symptoms, urogenital atrophy, vasomotor instability, sex dysfunction, osteoporosis