Breast & Axillae

Front 1

The female breast extends from the ____ down to the ____ rib, and from the ___ across to the ____

Back 1

1. from the clavicle and 2nd rib down to the 6th rib
2. From the sternum to the midaxillary line

Front 2

The axillary tail of the breast tissue is called the ___

Back 2

tail of spence

Front 3

In what two ways can findings in the female breast be described?

Back 3

Quadrants
Clock from nipple and cm from center

Front 4

The uneven texture of breast tissue can be normal, termed ___

Back 4

physiologic nodularity

Front 5

Lymphatics from most of the breast drain toward ____

Back 5

the axilla

Front 6

Lymph drains from the central axillary nodes to the _____

Back 6

infraclavicular and supraclavicular nodes

Front 7

Define galactorrhea.

Back 7

inappropriate discharge of milk-containing fluid.

Front 8

When is galactorrhea considred abnormal?

Back 8

If it occurs >6mos after childbirth or cessation of breast-feeding

Front 9

The most common palpable masses of the breast in women ages 15-25 is ___

Back 9

fibroadenoma - fine, round, mobile, non-tender

Front 10

In women between 25-50, ____ are breast masses that may be soft to firm, round, mobile, and may be tender.

Back 10

Cysts

Front 11

____ are breast masses described as "nodular and ropelike"

Back 11

Fibrocystic changes

Front 12

___ masses may be irregular, stellate, firm, not clearly delineated

Back 12

cancerous

Front 13

In women over 50, palpable masses are ___

Back 13

cancer until proven otherwise

Front 14

Risk of breast cancer ____ with age, and the lifetime risk for women is ___

Back 14

1. increases
2. 1 in 8

Front 15

Non-modifiable risk factors for breast cancer include:

Back 15

- age, family hx, age at first full-term pregnancy, early menarche, late menopause, breast denisty.

Front 16

Breast-feeding _____ risk of breast cancer.

Back 16

decreases

Front 17

Breast mammography is controversial in ages ____ but recommended ____

Back 17

controversial 40-50 yrs

Recommended annualy age 50+

Front 18

How often should clinical breast exam be performed?

Back 18

Every 3 years in ages 20-40, annually ages 40+

Front 19

Describe risk factors for breast cancer:

Back 19

- previous breast cancer
- affected mother or sister
- biopsy with atypical hyperplasia
- age
- early menarche
- late menopause
- late or no pregnancies
- previous radiation to chest wall

Front 20

Flattening of the normally convex breast suggests ___

Back 20

cancer

Front 21

What is the difference between nipple inversion and nipple retraction?

Back 21

Inversion - pointing inward but can be corrected when stimulated

Retracted - pulled back by underlying mass/ cancer

Front 22

Upon performing a breast exam, you note tender cords. You should consider what diagnoses?

Back 22

- mammary duct ectasia

Front 23

What signs in the nipple would suggest underlying cancer?

Back 23

thickening of the nipple and loss of elasticity

Front 24

Define gynecomastia.

Back 24

glandular enlargement (abnormal) of breast tissue in men

Front 25

How can you differentiate between fat enlargement and gynecomastia of the male patient?

Back 25

Gynecomastia involves palpable glandular tissue

Front 26

The term used to describe a sweat gland infection is ___

Back 26

hidradenitis suppurativa

Front 27

A patient presents with darkly colored, velvety axillary skin. This is called ____ and (is/is not) concerning.

Back 27

1. acanthosis nigricans
2. is, one form is associated with internal malignancy

Front 28

Milky discharge unrelated to a prior pregnancy and lactation is called ___

Back 28

nonpuerperal galactorrhea

Front 29

What are causes of nonpuerperal galactorrhea

Back 29

hypothyroid, pituitary prolactinoma, dopamine agonists,

Front 30

A patient presents with spontaneous bloody discharge from the right nipple. What should you consider?

Back 30

Intraductal papilloma, ductal carcinoma in situ, or Paget's disease of the breast.

Front 31

In the patient with a previous mastectomy, what signs would suggest a recurrence of breast cancer?

Back 31

masses, nodularity, change in color, inflammation (especially inthe incision line)

Front 32

A 20 year old patient presents with a single, round, frm, and well delineated R breast mass. It seems to be mobile and is not tender. Her nipple and areola appear normal... what do you suspect?

Back 32

Fibroadenoma

Front 33

____ occur in women ages 30-50, are round, soft, well delineated and mobile masses that may be tender.

Back 33

Cysts

Front 34

___ occur in women ages 30-90, and may be singular or multiple hard, immobile nodules. They are not easily delineated and may present with nipple retraction.

Back 34

Cancer

Front 35

Describe the difference between fibroadenoma, cysts, and cancer in:
a) retraction
b) tenderness
c) mobility
d) shape

Back 35

a) only present in cancer
b) Cysts may be tender, others usually nontender
c) Cancer is fixed, others mobile
d) Fibroadenoma: round, disclike or lobular
Cyst: round
Cancer: irregular or stellate

Front 36

Non-malignant causes of retraction of the nipple are:

Back 36

fat necrosis, mammary duct ectasia

Front 37

Describe 6 visible signs of breast cancer:

Back 37

1. retraction signs
2. abnormal contours (loss of convexity)
3) dimpling
4. nipple retraction and deviation
5. Edema of the skin
6. Paget's Disease of the nipple

Front 38

In ____, starts as a scaly eczema like lesion that may weekp, crust, or errode. It continues to dermatitis of the areola and erosion of the nipple.

Back 38

Paget's disease of the nipple

Front 39

A patient presents with inflammation, with small dimples and an "orange" appearance to the R breast. This is called ___ and suggests ___

Back 39

1. Peau d'Orange
2. Inflammatory breast CA

Front 40

Another term for the suspensory ligaments of the breast is ____

Back 40

Cooper's Ligaments