Term
| Is breast cancer usually painful? |
|
Definition
| No, as a rul breast cancer ins't painful, lole symptom in BRCA less than 10% of the time |
|
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Term
|
Definition
| breast pain, can be cyclic or non-cyclic, anxiety causing |
|
|
Term
| what are fibrocystic changes |
|
Definition
| an imbalance between estrogen and progesterone produces excessive ductal stimulation, proliferation and stromal edema |
|
|
Term
| what are some things that cause breast tenderness |
|
Definition
| menstrual cycle, pregnancy, caffeine and sodium, nicotine, HRT, trauma, muscular pain |
|
|
Term
| are fibrocystic changes painful/tender |
|
Definition
| yes, due to hormonal stimulation and or estrogen excess |
|
|
Term
| bilateral, not localized mastalgia is likely cyclic or non-cyclic |
|
Definition
|
|
Term
| when in the cycle does cyclic mastalgia occur/resolve |
|
Definition
| luteal phase, improves with menses |
|
|
Term
| is mastalgia over 40, constant and no relationship to menses likely cyclic or non-cyclic |
|
Definition
|
|
Term
| which mastalgia is more worrisome, cyclic or non-cyclic |
|
Definition
|
|
Term
| what other systems do you want to r/o for cause of pain if a patient over 40 presents with non-cyclic pain |
|
Definition
| cardiac/respiratory (SOB, palpitations) |
|
|
Term
| What are some dietary changes/supplements a patient with mastalgia for a CC could try |
|
Definition
| elliminate caffine (or cut in half), soy products, vitamin E, magnesium, evening primrose oil, decrease fat |
|
|
Term
| If a patient is on OCPs and has mastalgia for a CC, what could you do to manage hormones? |
|
Definition
| Try a OCP with less estrogen |
|
|
Term
| What pharmacologic management could you try for a patient with mastalgia after trauma? |
|
Definition
|
|
Term
| What could a differential diagnosis be for a patient with mastalgia in pregnancy |
|
Definition
|
|
Term
| What are some non-pharmacologic measures for mastalgia |
|
Definition
| Supportive bra (no underwire), reassurance that only 1 in 10 pain with breast cancer, encourage pt to stop touching breasts for 30 days |
|
|
Term
| what is a pharmacologic treatment for mastalgia |
|
Definition
|
|
Term
| what is physiologic nipple discharge? |
|
Definition
|
|
Term
| what is pathologic nipple discharge |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is it important to rule out with nipple discharge (esp. if serosangunous) |
|
Definition
|
|
Term
| if discharge is milky, with stimulation, bilateral, multiple ducts, is it likely malignant or benign? |
|
Definition
|
|
Term
| what tests do you want to order with a woman with galactorrhea? |
|
Definition
|
|
Term
| What can cause galactorrhea besides pregnancy |
|
Definition
| medications, thyroid, stress, pituitary tumor |
|
|
Term
| what do you want to do on PE for CC of nipple discharge |
|
Definition
| try to recreate it in office |
|
|
Term
| What tests do you run for serosangunous discharge? |
|
Definition
| hemoccult or cytology, but data does not support this, instead send to specialist for needle biopsy of duct |
|
|
Term
| What test do you order if prolactin is elvated |
|
Definition
|
|
Term
| What is an intraductal papilloma |
|
Definition
| serosanguineous or watery discharge, small benign tumor in duct |
|
|
Term
|
Definition
| milk filled cyst, masses on lactating patient |
|
|
Term
|
Definition
| dilatation and inflammation, common short term problem |
|
|
Term
| What are differentials of nipple discharge |
|
Definition
| intraductal papilloma, galactocele, duct ectasia |
|
|
Term
| If PE for nipple discharge reveals a benign cause, how do you treat? |
|
Definition
| avoid breast stimulation X 30 days |
|
|
Term
| What is a medication that can be used for nipple discharge (with a referral) |
|
Definition
| bromocriptine- lots of SE's |
|
|
Term
| What percent of all breast masses are benign? |
|
Definition
|
|
Term
| Must you always rule out breast CA in a mass? |
|
Definition
| yes, a breast lump is assumed to be cancer until proven otherwise in postmenopausal women |
|
|
Term
| What is the most common breast mass? |
|
Definition
|
|
Term
|
Definition
| Hormonally caused overgrowth of stromal and epithelial cells in ducts |
|
|
Term
| What is the treatment for a fibroadenoma |
|
Definition
| measure q 6 months, biopsy and mark them if they change |
|
|
Term
| Are fibroadenomas usually single or multiple? unilateral or bilateral? |
|
Definition
|
|
Term
| What lump can be rapid during pregnancy? |
|
Definition
| fibroadenoma (d/t estrogen) |
|
|
Term
| WWhat type of mass is typically firm, well-delineated, freely-mobile, non-tender to slightly tender? |
|
Definition
|
|
Term
| What test do you order for a breast lump if the patient is >35? |
|
Definition
| diagnostic mammogram (not screening) |
|
|
Term
| What test do you order for < 35 yo with a breast lump |
|
Definition
|
|
Term
| What do you do for follow up after radiology? |
|
Definition
| Go over rsults in person and in 3-6 months feel lump again for changes |
|
|
Term
|
Definition
| rare form of nipple cancer, rapid growth, poor prognosis |
|
|
Term
|
Definition
| orange peel skin- dimpled texture, swollen, inflammatory breast |
|
|
Term
| What type of breast mass feels discrete, tender, mobile, may fluctuate with the menstrual cycle |
|
Definition
| cyst, cyst fluid and inflammation found on sampling |
|
|
Term
| What breast mass is discrete, soft, non-tender, may or may not be mobile? |
|
Definition
| lipoma, fatty tissue found on tissue sampling |
|
|
Term
| What type of breast mass is ill defined, firm, non-tender, non-mobile |
|
Definition
| fat necrosis, necrotic fat with inflammation found on sampling |
|
|
Term
| What type of breast mass is discrete, firm, round, mobile, findings similar to a fibroadenoma but mass is usually larger, may observe stretching of skin due to rapid tumor growth |
|
Definition
| phyllodes tumor- stromal hypercellularity with glandular and ductal elements found on sampling |
|
|
Term
| what breast lump is discrete, non-tender, non-mobile, may be non-plapable with incidental diagnosis on imaging studies |
|
Definition
| hamartoma, glandular tissue, fat, and fibrous connective tissue found on sampling |
|
|
Term
| what type of breast mass is discrete, firm and sometimes tender |
|
Definition
| galactocele, fat globules found on sampling |
|
|
Term
| What type of breast tissue sampling procedure is used for a palpable breast mass or thickening to differentiate solid and cystic mass, tissue for cytologic evaluation is aspirated |
|
Definition
| fine-needle aspiration biopsy |
|
|
Term
| What type of breast tissue sampling procedure is used for a calcification or density seen on mammogram, uses a large bore needle to obtain cores of tissue for histologic examation and uses sterotatic mammography for targeting |
|
Definition
| stereotactic core needle biopsy |
|
|
Term
| What type of breast tissue sampling procedure is used for solid lesions seen on US, uses large bore needle, obtains core of tissues for hisologic exam |
|
Definition
| ultrasound guided core needle biopsy |
|
|
Term
| What type of breast tissue sampling procedure is used for lesions visible only with MRI, uses IV contrast |
|
Definition
|
|
Term
| What type of breast tissue sampling procedure is used for density or calcification seen on mammogram that cannot be effectively assessed with a core biopsy and uses a wire to localize occult mammographic abnormality |
|
Definition
| needle localized breast biopsy |
|
|
Term
| What type of breast tissue sampling procedure is used for palpable breast mass, thickening, or skin change if needle biopsy is not feesable, is a surgical procedure, mass is removed with a surrounding margin of normal tissue |
|
Definition
|
|
Term
| What breast imaging is best for detecting calcifications, densities and architectural distortion but cannot show if a density is solid or cystic |
|
Definition
|
|
Term
| what breast imaging is best for detecting solid or cystic masses but cannot show calcifications |
|
Definition
|
|
Term
| what breast imaging is best at detecting tissues with an increased blood flow such as tumors but is limited due to expense and high rate of false-positives |
|
Definition
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