Breast Disease For Usmle Step 2

Front 1

pathophysiology for fibrocystic breast dz

Back 1

exaggerated stromal response to hormones and growth factors

Front 2

age of pt with fibrocystic breast dz

Back 2

30-40 yo

Front 3

presentation of fibrocystic breast dz

Back 3

painful breast mass
cyclic changes

Front 4

how to dx fibrocystic breast dz

Back 4

if it looks suspicious, do mammogram, u/s, or bx

Front 5

tx of fibrocystic breast dz

Back 5

reduction in caffeine, chocolate, avoiding trauma, wearing support bras

Front 6

pathophys of fibroadenoma

Back 6

benign tumor with epithelial and stromal components

Front 7

age of pt with fibroadenoma

Back 7

20-30 yo

Front 8

presentation of fibroadenoma

Back 8

non-tender breast mass
usually solitary, chnges with cycle

Front 9

dx of fibroadenoma

Back 9

physical exam
if >5cm, r/o cystosarcoma phyllodes with FNA

Front 10

tx for fibroadenoma

Back 10

if no family history and mass not suspicious, just continue to follow
if large or worrisome, excisional bx

Front 11

pathophys of cystosarcoma phyllodes

Back 11

rare variant of fibroadenoma, involves epithelium adn stroma

Front 12

presentation of cystosarcoma phyllodes

Back 12

large, bulky, mobile mass
overlying skin is warm shiny, red, and engorged

Front 13

dx of cystosarcoma phyllodes

Back 13

must get tissue sample

Front 14

tx of cystosarcoma phyllodes

Back 14

wide local excision with 1cm margins if tumor is small

simple mastectomy if tumor is large

Front 15

pathophys of intraductal papilloma

Back 15

epithelial lining of lactiferous ducts --> proliferate

Front 16

age of women with intraductal papilloma

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pre-menopausal

Front 17

presentation of intraductal papilloma

Back 17

bloody nipple d/c

Front 18

dx of intraductal papilloma

Back 18

serosanguinous fluid to cytology to r/o invasive papillary carcinoma

Front 19

tx of intraductal papilloma

Back 19

excision of involved duct

Front 20

pathophys of mammary duct ectasia

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inflammation of ductal system --> dilated mammary ducts

Front 21

age of women with mammary duct ectasia

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peri or post-menopausal

Front 22

presentation of mammary duct ectasia

Back 22

non-cyclic breast pain
sticky, multicolored b/l d/c

Front 23

LCIS

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lobular carcinoma in situ
prolif of epithelial cells contained to lobules

Front 24

age of women with lcis

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mid 40's, premenopausal

Front 25

pt presentation of lcis

Back 25

non-palapable, not seen on mammo, a finding when there is bx for another indication

Front 26

tx of lcis

Back 26

local excision
follow closely for invasive breast ca

Front 27

pathophys of dcis

Back 27

prolif of malignant epithelial cells in mammary duts, w/o spread into stroma

Front 28

age of women with dcis

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mid 50's

Front 29

presentation of dcis

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10% have a palpable mass
90% are seen on screening mammo

Front 30

dx of dcis

Back 30

needle bx or excisional bx

Front 31

tx of dcis

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surgical excision of all microcalcifications with wide margins

possible simple mastectomy

radiation tx to reduce ris of recurrence, if margins are inadequate

Front 32

most common invasive breast malignancy

Back 32

infiltrating ductal carcinoma

Front 33

presentation of paget's disease of breast

Back 33

crusting, scarring, eroded nipple
eczematous change of nippple
usually associated with dcis

Front 34

presentation of inflammatory breast carcinoma

Back 34

peau d'orange