Show:
Anatomy
Physiology
Diagnosis
Benign
Cancer
100
Where do the breast lymphatics ultimately drain?
Axillary Nodes
100
Cyst that has internal echoes during sono, can be indistinguishable from solid masses at times?
Complicated cyst - Treatment: aspiration, send for culture if fluid is purulent
100
Describe features of a benign breast lump?
smooth, round, mobile
100
Focal eczematous rash of the nipple
Paget disease of the nipple. Caused by migration of ductal carcinoma cells to the surface of the nipple, causing skin breakdown. 60% of cases have associated mass
100
This genetic syndrome accounts for 5-7% of all breast cancers?
BRCA mutation. BRCA 1: early age at breast cancer diagnosis, lifetime risk 35-80%, high grade, associated ovarian cancer (16-57% risk). BRCA 2: breast cancer at similar age to those without genetic syndromes, associated with ovarian, pancreas, prostate, biliary system cancer associated with male breast cancer.
200
What do lobules contain?
10-20 milk producing acini
200
Focal developmental abnormality of breast lobule, comprised of glandular and cystic epithelial structures surrounded by cellular stroma?
Fibroadenoma
200
This screening test involves magnification, extra compression, extra views?
Diagnostic mammogram
200
Cyst that has internal echoes during sono, can be indistinguishable from solid masses at times
Complicated cyst. Treatment: aspiration, send for culture if fluid is purulent
200
When does ACOG recommend beginning screening mammography?
40 years of age
300
Saccular dilation below the nipple?
Lactiferous sinus
300
Treatment of a simple cyst?
Does not require management, may be aspirated if painful - If recurrent, excise
300
Two views incorporated in screening mammogram?
medial lateral oblique, cranial caudal views
300
Focal developmental abnormality of breast lobule, comprised of glandular and cystic epithelial structures surrounded by cellular stroma.
Fibroadenoma
300
Most common distant metastatic site of breast cancer?
Bone
400
Numerous lubricating sebaceous glands on areolae?
Montgomery glands
400
How do you treat pathologic nipple discharge?
Definitively diagnose and treat by subareolar duct excision (microductectomy)
400
Three components of a triple test?
examination, imaging, core needle biopsy - Concordant benign test is >99% accurate
400
Histologic finding that is a marker of increased breast cancer risk, can have subsequent breast cancer in either breast
Lobular Carcinoma in Situ
400
Modifiable risk factors for breast cancer? (2)
obesity, sedentary life style
500
Describe the drainage of the ductal system of the breast?
Acini-->terminal duct-->lactiferous duct-->lactiferous sinus. Each of these is a lobule (there are ~40 different lobules in a breast that drain into 12-15 ductal systems)
500
Tumors similar to fibroadenomas, but the stromal cells are monoclonal and neoplastic?
Phyllodes tumors
500
How long should you wait after biopsy to perform imaging?
minimum 2 weeks
500
Tumors similar to fibroadenomas, but the stromal cells are monoclonal and neoplastic
Phyllodes tumors
500
Membrane tyrosine kinase that works on receptors to generate proliferation and survival of cancer, these patients are usually sensitive to herceptin
Her 2 Neu