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23 Cards in this Set
- Front
- Back
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young woman presents with a firm, nontender, mobile breast mass.
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has no family hx of breast cancer and is in good health so far
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What do you have to do to dx her? CAn you just assume this is a fibroadenoma?
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no you have to do at least an FNA or core needle biopsy and send to path
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AGain, what are the 3 components of a health maintenance exam?
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immunizations
cancer screens screens for common disease |
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What are some features of a fibroadenoma?
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firm, nontender, rubbery, mobile
usually these do NOT change with the menstrual cycle |
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I also remember a uWorld question where the answer was
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follow up after her next menstrual period
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What type of biopsy is usually firstline?
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FNA
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What are some features of breast cancer instead of fibroadenoma?
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fixed
nipple retraction bloody nipple discharge |
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How does FNA and core needle biopsy differ?
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FNA uses a vacuum attached to a small guage needle to suck some fluid and cells out of the mass.
a core needle biopsy just draws cells up into a large bore needle. |
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How does the histology differ between the two?
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FNA gives loose cells
Core needle can give a slide prep |
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How does excisional biopsy differ?
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it invovles removing the entire lesion and then judging under the microscpe
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Other breast masses and disease
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ok
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What is the most common benign breast disease?
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fibrocystic change
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What is FC change?
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basically just lumpy bumpy breast texture due to an exagerrated hormonal response of the breast tissue.
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Do postmenopausal women show FC change?
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it's quite rare- this is mostly a disease of premenopausal women because it undergoes cyclic changes with menses
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When is the pain/tenderness of fibrocystic change most pronounced?
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just before menses
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Do you need to get an FNA of FC change?
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only if there is one dominant mass
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What are some treatment options for FC change?
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lower caffeine intake, use NSAIDs, tighter bras and OCPs/progestins
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When is Danazol used for FC change?
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only in severely symptomatic cases
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what is the most common dominant breast mass in young women?
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fibroadenomas
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What is the "triple approach" to a dominant breast mass?
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H&P
imaging- US or mammogram biopsy |
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How does an intradctal papilloma present?
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with a bloody nipple but no identifiable breast mass
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What do you have to do for an intraductal papilloma?
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you have to do some ductal exploration in order to rule out cancers
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When is inflammatory breast cancer most common?
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in young women- these can be hard becasue they look a lot like mastitis
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