Management
A breastfeeding mother presents with a 5 cm firm, fluctuant, tender, erythematous area of her left breast at the 0300 position, 3 cm from the areola. What imaging modality is most appropriately to confirm the likely diagnosis?
Breast Ultrasound
Dx = Breast Abscess
Evaluation of nipple discharge begins with this first.
Breast examination
This is the most common benign breast disease in young women
Fibroadenoma
Per ACOG, what ages are recommended to discuss/recommend breast cancer screening
Age 40-74
If lifetime risk >20% = MRI
This resident always wins the team spirit award
Cat
A patient has this risk of underlying breast cancer with a BIRADS score of 5
>95%
Dark green nipple discharge is related to the content of this within the discharge
Cholesterol diepoxides
Paget's disease of the nipple is associated with this underlying pathology in 66% of affected individuals
DCIS (66%)
Invasive cancer (33%)
This imaging modality is most appropriate for a patient with lifetime risk of breast cancer >20%
MRI
This individual recently confirmed their seventeenth fellowship interview
Gabi
This adjuvant hormonal therapy is used following identification/management of estrogen/progesterone positive breast cancers.
Tamoxifen (pre or post-menopausal)
Hemoccult test
If (-) = reassure
If (+) = imaging
Infiltrating ductal carcinoma constitutes this percentage of invasive breast cancer diagnoses
80%
This breast cancer risk model is best suited for a 40 year old female with a family history of first degree relative with male breast cancer and multiple bilateral breast cancer diagnoses
BRCAPRO, Tyrer-Cuzick, BOADICEA
This resident broke their leg, hand, and received braces within a 2 week time frame.
Kyle.
6th grade was not fun.
A female with known germline-caused progesterone and estrogen receptor negative breast cancer is most likely to be affected with what specific BRCA gene mutation?
BRCA1
BRCA2 = ER (+), PR (+) = Tamoxifen!
Most pathologic nipple discharges are caused by this
Benign Intraductal Papilloma
A 68 year patient with recently diagnosed and managed estrogen receptor positive invasive breast cancer should be on this adjuvant hormonal therapy category whom previously was evaluated for post-menopausal bleeding 3 years ago
Aromatase inhibitor
Anastrozole, Letrozole, Exemestane
This modulator should be considered when 5 year risk of breast cancer in females over age 35 exceeds 1.7%
Tamoxifen
This resident sold their post-hole digging machine following a deck building incident in 2020.
Baracy
Premenopausal bilateral salpingo-oophorectomy reduces breast cancer risk by this amount in patient's with hereditary breast-ovarian cancer syndrome.
37 to 72%
90% reduction in breast cancer risk with bilateral mastectomy
Which 3 preliminary laboratory tests should be ordered to further investigate spontaneous, multi-duct non-bloody nipple discharge?
Prolactin
bHCG
TSH
This is the strongest risk factor associated with development of breast cancer
female gender
27%
This resident previously played in soccer tournaments around the world
Gabi.