Treatment of Breast Disease

Question 1

A scaly, eczema-like erosion of the nipple

Answer 1

Paget’s disease

Question 2

causes of abnormal lactation

Answer 2

• tranquilizers
• OICs
• Manuel stimulation
• Infection
• Malignancy

Question 3

Breast/LN exam

Answer 3

1. Supraclavicular + infraclavicular LNs
2. Examine Breast w/ pt in sitting position andf arms at side, then arms raised over head
3. Axillary LNs
4. Breast w/ pt in supine

Question 4

Axillary LN nodules

Answer 4

Metastasis/lymphoma: fixed, firm, immobile, irregular LNs > 1 cm

Infection or Carcinoma: Enlarged, painful, tender LNs matted together

Question 5

Firm, smooth, round, well-defined, extremely movable breast mass

Tx?

Answer 5

Fibroadenoma

Tx Sx Excision

Question 6

Clear, straw-colored, or greenish drainage from breast

Answer 6

Fibrocystic Dx

Question 7

Spontaneous, bloody unilateral nipple discharge

Answer 7

intraductal papillomas

Question 8

regular mass with ill defined margins; not movable and is inseparable from adjacent tissues

Answer 8

Breast Cancer

Question 9

Techniques used to ID HER2 gene

Answer 9

• FISH or fluorescent in-situ hybridization

- IHC

Question 10

Ki67 + MIB-1

Answer 10

Proliferation markers in breast tumors

Question 11

Mammogram recommendations

Answer 11

• 35-40 YO baseline mammogram
• 40-50 YO consult physician every year
• > 50 YO mammogram every year

Question 12

Breast cancer T staging

Answer 12

T1: < 2 cm (a. Not fixed to pectoralis b. fixed)
T2: 2 - 5 cm
T3: > 5 cm
T4: Invading chest wall (a. fixation, b. edema or ulceration c. both d. inflammatory)

Question 13

Breast cancer N staging

Answer 13

N0 - None
N1 movable palpable nodes (a not suspicious or b)
N2 Nods contatining metastases which are fized to another
N3 Supraclavicular/infraclavicular nodes w/ metastases