The Breast: Benign and Malignant Disease Flashcards
Anatomy of the Breast
consists of fat, skin, fibroglandular tissue, nipple and areola
Breast extends from the infraclavicular space to inframammary fold, sternum to latissimus dorsi and to axilla
loosely attached to the pectoralis fascia
Breast imaging terminology
Screening mammography: recommended ages 50-75 or 10 years earlier than youngest relative diagnosed
Diagnostic mammogram: do if screening mammogram is abnormal
Ultrasound: adjunct to diagnostic mammogram and primary diagnostic tool in patients less than 30 yo
What are fibrocystic changes
Normal change that occurs in the breast in response to hormones
Includes fibrosis, cysts, hyperplasia, metaplasia, adenosis
Nipple discharge
Usually benign process
Bilateral milky discharge may be galactorrhea- check for pregnancy or elevated prolactin levels from prolactinoma
Clear or greenish discharge is normal-related to underlying duct ectasia/inflamm
Bloody discharge-usually d/t intraductal papilloma, benign growth usually not cancer
Risk Factors for breast cancer
early menarche or late menopause first birth after age 30 or nulliparity family history atypical hyperplasia LCIS known carrier of BRCA 1 or 2 personal hx of ovarian, colon or uterine cancer hormone replacement therapy radiation exposure
Surgical biopsy terminology
Incisional bx: removing a piece of the suspicious mass for diagnosis only
Excisional bx: completely excising mass for diagnosis, if clear margins may be adequate cancer surgery
Lumpectomy: excision of mass and normal surrounding tissue, terminology reserved for treatment of cancers not benign lesions
Types of chemotherapy
adriamycin/cyclophosphamide-4 cycles
taxol added if positive lymph nodes or poor prognostic tumor, adjunct to standard chemo
Herceptin-adjuvent therapy in tumors with Her2 gene overexpression
Hormone therapy
Tamoxifen
Aromatase inhibitors
