The Breast Flashcards

1
Q

Breast lymph drains to…

A

axillary nodes

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2
Q

If Gail Model risk score is > _____%, consider ____ therapy to reduce estrogen and risk.

A

1.66

Tamoxifen

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3
Q

If you don’t feel a mass but feel something that is like a bag of peanuts, what do you do?

A

Check to see if it’s symmetric bilaterally. If not, evaluate further w/imaging.

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4
Q

Nipple discharge or Apiration–>What test?

A

Cytology (cells); 80% accurate

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5
Q

Core biopsy or Excisional biopsy—>what test?

A

pathology (tissue); More accurate

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6
Q

When are mammograms not useful? Then what would you do?

A

Not useful w/dense, small breasts.
US.
(this is more applicable for young patients; 30-35)

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7
Q

Negative US means that the mass is…

A

solid (aka not a cyst)

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8
Q

Negative mammogram means what?

A

Nothing. Some tumors are not radio opaque or may be too small.

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9
Q

Negative US and Mammogram means….

A

You need to do an excisional biopsy. (NOT FNA).

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10
Q

Birads 1 & 2… what do you do?

A

repeat mammogram in one year.

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11
Q

Birads 3…what does this mean? what do you do?

A

Benign appearing mass. 1% chance of becoming cancer. Repeat mammogram in 6 months.

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12
Q

Birads 4… what does this mean? what do you do?

A

Theses are clusters of calcifications. 10-50% chance of cancer. So biopsy.

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13
Q

Birads 5… what does this mean? what do you do?

A

Solid, spiculated mass.

BIOPSY (yesterday)! 90-97% chance of cancer.

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14
Q

Birads 6 means?

A

known malignancy

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15
Q

Galactogram/ductogram is used for what?

A

evaluate nipple discharge from a single duct

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16
Q

When might you use an MRI for breasts?

A

Looking at extent of breast CA
Lymph nodes
Screening for cancer in young patients w/extensive family hx
Evaluating breast implants
Evaluating lumpectomy sites for recurrence

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17
Q

Mass–> Positive Mammogram or US. DO what?

A

Core biopsy (with wire localization if you can’t feel it)

18
Q

Painless, slow growing, well circumscribed, firm, rubbery nodule. What is it likely to be? What should you do?

A

Fibroadenoma most likely, espec if young.

NEED biopsy still. (core or excisional)

19
Q

Symmetric or asymmetric enlargement of breast tissue before age 12.

A

Juvenile hypertrophy or prepubertal gynecomastia.

20
Q

Hypoplasia of chest wall/no pec muscle

A

Poland syndrome

21
Q

Accessory breast tissue (extra nipples, mass in axilla)

A

Polythelia/Polymastia

22
Q

breast pain prior to menses

A

cyclical mastalgia

23
Q

constant severe breast pain

A

mastodynia

24
Q

mastitis and abscess are common in who?

A

nursing moms

25
Q

If mastitis doesn’t get better w/abx…do what?

A

biopsy. be scared of inflammatory breast cancer.

26
Q

milk filled cyst, tx w/I&D

A

galactocele

27
Q

management of complex cysts

A

aspirated then US every 6 mos out to 2 years to document stability

28
Q

do cysts need re-aspiration?

A

sometimes. once. then excise if it recurs. Also excise if bloody.

29
Q

Nipple discharge— do what? what is the most common cause?

A

MC: Intraductal papilloma

Do cytology. If unilateral, do ductogram. Prolactin level. Rarely cancer

30
Q

stellate densite on mammogram; need excising

A

radial scar

31
Q

Small, round, benign fatty tumor. Needs biopsy.

A

Lipoma

32
Q

benign lump following trauma.

A

Fat necrosis

33
Q

superficial thrombophlebitis of breast. Cordlike. Following trauma or exercise. Tx w/NSAIDS and time.

A

Mondor’s dz

34
Q

Since DCIS becomes invasive ductal carcinoma, what do you do?

A

lumpectomy + radiation or mastectcomy - radiation

35
Q

LCIS is not premalignant, but is a RF for…

A

DUCTAL carcinoma

36
Q

What do you do about LCIS

A

usually nothing. Could do tamoxifen, mastectomies, etc… but usually nothing.

37
Q

MC breast cancer

A

invasive ductal carcinoma (need mastectomy)

38
Q

what is special about inflammtory breast cancer tx

A

chemo or XRT first before mastectomy

39
Q

MC types of metastatic carcinoma

A

squamous, pseudosarcomatous

40
Q

Pagets dz means…

A

pts have DCIS or invasive ductal carcinoma. Need MRM (modified radical mastectomy

41
Q

MRM means what?

A

mastectomy plus lymph nodes