Tx: Breast Conditions Flashcards

- Breast conditions - Breast cancer - Lactation conditions

1
Q

Fibrocystic disease

A
  1. Avoid trauma
  2. Use good supportive bra
  3. OTC analgesics
  4. Encourage breast self exam and regular f/u
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2
Q

Fibroadenoma

A
  1. Watch and f/u
  2. Removal if obstructive or suspicious
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3
Q

Cystosarcoma phyllodes

A
  1. Wide excision if nonmalignant
  2. Simple mastectomy = controversial tx of malignant form
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4
Q

Galactorrhea (nipple discharge)

A
  1. Refer to surgery if necessary –> removal of affected duct
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5
Q

Duct ectasia

A
  1. Total duct excision (resolves discharge, allows nipple eversion)
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6
Q

Fat necrosis

A
  1. Self-limiting
  2. R/o malignancy or carcinoma if not resolved in 2 weeks (surgical bx)
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7
Q

Mastitis - Pharm & Procedural

  • Staph, MRSA tx
A
  1. May need abx
    • Staph: Penicillin, Dicloxacillin, Amoxicillin, Augmentin, Cephalexin, Doxycycline, TMP-SMX
    • MRSA: Doxycycline, TMP-SMX
  2. I&D if abscess
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8
Q

Mastitis - Nonpharm (6)

A
  1. Empty the breast
  2. Rest
  3. Anti-inflammatories
  4. Warm compresses
  5. Well-fitting bra
  6. Hydration
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9
Q

Breast abscess

A
  1. Early stage - abx, continue breastfeeding
  2. Later stage - abx, I&D, d/c breastfeeding
  3. Non-lactating - I&D
  4. Possible excision if duct involvement
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10
Q

Gynecomastia

A
  1. D/c meds
  2. Breast surgeon
  3. Onc referral
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11
Q

Breast cancer: ductal carcinoma in situ

A
  1. Lumpectomy + radiation
  2. Masectomy
  3. ER (+): hormone therapy
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12
Q

Breast Cancer: Lobular carcinoma in situ

A
  1. Excisional bx +/- chemoprevention (Tamoxifen)
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13
Q

Breast cancer stage 0-3

A

Curable!

  1. Surgery: lumpectomy or mastectomy
  2. +/- radiation, chemo, HER2 directed therapy, hormone therapy
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14
Q

Breast cancer stage 4

A

Incurable

  1. Palliative radiation and chemotherapy. No surgery.
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15
Q

Mastectomy often involves…

A

sentinel LN bx and possible lymphadenectomy (radical mastectomy)

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16
Q

Radiation indications

A
  1. Lumpectomy
  2. Post-mastectomy with high rate of recurrence (+ deep margins, + axillary LN)
17
Q

Nipple pain with feeding

A
  1. Give it time
  2. change feeding position
  3. lactation consultant
  4. Nipple shield (avoid if can)
18
Q

Mild engorgement (7)

A
  1. Cool compress
  2. Warm showers
  3. Manual expression
  4. Analgesics
  5. Fluids
  6. NSAIDs/APAP
  7. Cabbage leaves
19
Q

Moderate-severe engorgement

A
  1. Empty with pump
  2. Acupuncture
  3. US
20
Q

Clogged duct (9)

A
  1. Nurse often
  2. Use gravity
  3. Massage
  4. Hot shower
  5. Vibration
  6. Cabbage leaves
  7. Fluids
  8. Lecithin (2T)
  9. NSAIDs/APAP