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28 Cards in this Set

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What is the PRIMARY FUNCTION OF BREAST
Lactation
Where is the primary lymphatic drainage from breast?
AXILLA! ~97%.
Where breast carcinomas arise from?
TDLU - Terminal duct lobular units.
What are the breast development processes during PUBERTY? during PREGNANCY? during LACTATION?
Puberty --> Elongation of ducts...ESTROGEN DRIVEN

Pregnancy --> Tubuloalveolar development (PROGESTERONE and PROLACTIN)

Lactation --> PROLACTIN (insulin and cortisol)
Which causes more mitotic activity: Estrogen + Progesterone OR Estrogen only.
Estrogen and Progesterone TOGETHER have GREATER MITOTIC ACTIVITY.

Therefore, mitotic rates are higher during LUTEAL PHASE than during FOLLICULAR PHASE.
Even though prolactin is present during PREGNANCY, why is there no lactation?
Estrogen and progesterone inhibit PROLACTIN.

PROLACTIN with the inhibitory hormones thus leads to tubuloalveolar
TRUE/FALSE

Ovaries are required for lactation.
NO!

HPA axis is functioning, then perfect.
When does lactation cease upon weaning?

How long does it take breasts to return to pre-pregnancy state (though not the same!)
Lactation within 7-10 of weaning

Takes 3-4 months to return to normal
What happens to breasts during menopause?
Decrease in estrogen and progesterone levels results in PROGRESSIVE INVOLUTION of ducts and glands.
Which is more common: Asymmetrical breasts or underdeveloped breasts?
ASYMMETRICAL BREASTS! Can be due to trauma, radiation.
What is galactorrhea?
Persistence of discharge >6 months post-partum
If there is a LACK OF MILK UPON BIRTH, what could be cause?
Remember...Milk production driven by prolaction. Prolactin secreted by anterior pituitary.

Anterior pituitary can infarcted during labor and delivery (SHEEHAN'S SYNDROME)
What are risk factors for breast cancer?
BAD RISK FACTOR:
- early menarche
- delayed menopause
- FEW pregnancies

MORE pregnancies decreases total estrogen exposure time.
How many lobes are typically found in breast?
~15-20
What are physical signs of breast cancer?
Bleeding/nipple discharge

Mass

Redness
What are the two most common species of bacterial infection in post-partum breast infections
Staph and strep
What is inflammatory breast cancer?
Redness of breast (not all redness is inflammatory breast cancer)

Biopsy shows cancer cells clogging lymphatics WITHOUT inflitrate.
What are symptoms of FIBROCYSTIC CHANGES (FCC's)
CYCLIC (because hormone sensitive) pain. Tenderness, palpable breast irregulatiry .

Usually found during reproductive years
Why are FCC's important?
They can be identified on mammogram and biopsied and analyzed.

Some FCC's are markers for cancer risk.
Are most spots on mammogram cancer?
NO, usually benign FCC's or fibroadenomas.
What are non-proliferative FCC's?
cysts, fibrosis, adenosis, apocrine metaplasia

NO INCREASED RISK LEVEL FOR BREAST CANCER WITH NPFCC's
What are proliferative FCC's?

Which is particularly important in terms of CANCER RISK?
Sclerosing Adenosis (SLIGHTLY INCREASED RISK)

Usual ductal hyperplasia

Atypica Ductal/Lobular Hyperplasia (ADH/ALH)...ADH/ALH...of the 15% of women who are diagnosed with ADH/ALH, they can go on to develop cancer...ESPECIALLY IF THEY HAVE FAMILY HISTORY.

HIGHEST RISK OF ADH/ALH with atypia.
What is the MOST BENIGN TUMOR IN THE BREAST?

What part of breast does this tumor arise?
FIBROADENOMA. Soft, rubbery, easily palpable mass.

Usually excised. ALWAYS BENIGN.

FIBROADENOMA COME FROM STROMA.
Aside from fibroadenomas, what is the other type of STROMAL TUMOR?
Phyllodes tumor...

USUALLY BENIGN, though can metastasize.
When should women begin mammogram screening
AT 40, 35 if age-related.
Which is more malignant?

Invasive ductal/lobular carcinoma OR in situ ductal/lobular carcinoma?
INVASIVE!!
CRUSTING AND ULCERATION of the nipple means?
PAGET's DISEASE. a sort of breast cancer.
What is gynecomastia?
Common disorder...likely due to imbalance of estrogen:androgen ratio (tilts towards estrogen)

THIS CONDITION IS BENIGN> Remove for cosmetic purposes.