Surgical Breast

Question 1

_____________________________- presents in premenopausal women (typically age 18–30) with cyclical breast pain, usually before the onset of menstruation, and lumpy, tender breasts. But the lumps and bumps “migrate.” Of course, nothing migrates. Rather, one focus of proliferation and poor regression will resolve while another focus of proliferation and poor regression arises. More accurately, the breast nodules, the lumps and bumps, come and go. Thus, any breast mass will be nonuniform and the breasts affectedasymmetrically. Nodules that persist should be considered worrisome, but most cases of fibrocystic changes need no investigation.

Answer 1

Symptomatic fibrocystic change

Question 2

an increased number of terminal ductules without an increase in interlobular stroma.

Answer 2

adenosis, Overproliferated or under-regressed glands on histology is called adenosis

Question 3

Stromal changes are caused by excess stroma. There are two disease states: ___________________________

Answer 3

fibroadenoma and phyllodes tumor.

Question 4

_______________________is the second most common breast mass (after carcinoma) and the most common mass in women under 30 years old. They almost always arise in the teens and early 20s and are never new after 40.

Answer 4

Fibroadenoma

Question 5

___________________ is a fast-growing, estrogen-independent stromal tumor that presents in postmenopausal women.

Answer 5

Phyllodes tumor

Question 6

Tx for phyllodes tumors

Answer 6

surgical resection , because these grow rapidly and may become malignant

Question 7

How does physical exam differ for benign versus not benign breast mass?

Answer 7

Although you can palpate to differentiate a breast mass that is probably not cancer (firm, smooth, fully mobile, without axillary lymphadenopathy) from one that is probably cancer (fixed, multiple contours, with axillary lymphadenopathy), the physical exam alone is insufficient to be certain.

Question 8

If a woman is over 30 years old with a new breast mass, she is evaluated with

Answer 8

both mammogram and ultrasound.

Question 9

In a pt under 30 with a new breast mass we want to eval using…

Answer 9

If she is under 30, the breast tissue will be too dense for a mammogram, so ultrasound is used to evaluate the mass.

Question 10

How do we work up a new breast mass?

Answer 10