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74 Cards in this Set

  • Front
  • Back
Muscles forming the floor of the breast?
pec major, pec minor, serratus anterior, latissimus dorsi, subscapularis, external oblique, and rectus abdominis
Vascular supply to the breast?
primarily via branches of internal mammary artery and the lateral thoracic artery
Greatest amount of glandular tissue lies in which breast quadrant?
upper outer quadrant
Tiny sebaceous glands on the areola surface
Montgomery tubercles (expected)
Most likely location for supernumerary nipples or breast tissue?
along the mammary ridge that extends from the axilla
Superficial nodes that drain breast that are more accessible and relatively easy to palpate when enlarged?
axillary nodes
Nodes located along the lower border of the pec major inside the lateral axillary fold?
anterior axillary (pectoral) nodes
Nodes located along the lateral border of the scapula and deep in the posterior axillary fold?
posterior axillary (subscapular) nodes
Nodes that may be felt along the upper humerus?
Lateral axillary (brachial) nodes
Thelarche definition
breast development
Most common tanner stage for females to begin menstruating?
tanner stage 4
Average interval from appearance of the breast bud to menarche?
2 years
Appearance of breast bud coincides with which tanner stage?
tanner stage 2
Onset of menses is unusual before which Tanner stage?
anything before stage 3
Reason breast tissue becomes softer and looser during pregnancy
Hormones induce glandular tissue to displace connective tissue
What changes occur in the areolae during pregnancy?
areolae become more deeply pigmented and their diameter increases
What changes occur in the nipples during pregnancy?
The nipples become more prominent, darker, and more erectile.
What happens to the vasculature of the breast during pregnancy?
vascularization increases, causing veins to engorge and become visible beneath the skin
Breast secretion that occurs the first few days after delivery?
colostrum
How does colostrum differ from mature milk?
Colostrum contains more protein and minerals than mature milk
When does Mature milk production begin to replace colostrum production in a lactating woman?
2 - 4 days post delivery
What signals the breasts to produce milk instead of colostrum?
surging prolactin levels and declining estrogen levels
Do the breasts return to their prelactation size when a woman is no longer breast feeding?
The breasts rarely return to their prelactation size
Retroareolar area of the breast drains to which lymph nodes?
Interpectoral (Rotter) nodes into the axillary chain
Deep upper arm portion of the breast drains to which lymph nodes?
lateral axillary nodes (brachial)
Areola and Nipple are drained by which lymph nodes?
midaxillary, subclavicular, and supraclavicular nodes.
What do fibrocystic changes without proliferative breast disease do to the risk of developing breast cancer?
no effect on risk
Race that is more likely to die from breast cancer?
blacks
Race that is more likely to develop breast cancer?
whites
Women who start menstruating before age _____ have an increased risk for developing breast cancer
12
What effect did DES therapy on pregnant women in the 1940s - 1960s have on their rates of breast cancer?
slightly increased their risk of developing breast cancer
Best time for a woman of childbearing age to do her monthly breast exam?
2-3 days after her period
Second leading cause of cancer death in American women?
breast cancer
Most common type of cancer among women in the US?
breast cancer
How often should a woman over 40 get a clinical breast exam?
annually
Best position for inspection of the breasts during a breast exam?
patient in sitting position w/arms hanging loosely @ sides
Contraction of fibrotic tissue that causes retractions and dimpling of the breast occurs with what disease?
carcinoma of the breast
Edema of the breast causing the breast to have a peau d'orange appearance indicates what two things?
blocked lymph drainage or inflammatory carcinoma
Woman comes to your office complaining of the skin on her breast appearing thickened with enlarged pores and accentuated skin markings. Dx?
breast carcinoma
Unilateral venous patterns produce by dilated superficial veins may be a sign of what?
increased blood flow to a malignant cancer
Five D's related to nipples?
Discharge, depression, discoloration, dermatologic changes, deviation
A woman voices her concern about a peppering of nontender, nonsuppurative tubercles within her areola surrounding her nipple. You reassure her by saying:?
These are Montgomery tubercles (sebaceous glands) and are an expected finding
Peau d'orange associated with carcinoma is often seen first in which portion of the breast?
areola
A woman comes to your office voicing a concern about a retraction of a previously everted nipple. The medical student you have rotating with you asks you what the significance of that finding may indicate. You reply?
It suggest a malignant breast cancer
Recent unilateral inversion of a woman's nipple suggests what?
a malignant breast cancer
During a breast exam on a patient you've had in your practice for several years, you notice that her nipples are pointing in different directions. This change from baseline may indicate?
breast carcinoma
Supernumerary nipples are more common in ?
black women
Best way to assess the supraclavicular nodes?
hook your fingers over the clavicle and rotate them over the entire supraclavicular fossa
First sign of invasion of lymphatics by abdominal or thoracic carcinoma?
enlarged virchow nodes
A mother notes that her new born has enlargement of her breasts. When you squeeze the newborn's breast a small amount of milky white fluid is expressed. You reassure the mother by telling her: ?
The breast enlargement is due to transferred maternal estrogen and should disappear within about 2 weeks.
During your exam of a whiny adolescent female, one of the many things she complains about is that one of her breasts is larger than the other. You reassure her by saying: ?
Some asymmetry is common and that her reassure developing appropriately.
An adolescent male voices concern to you during an exam about a subareolar mass that is firm and tender. What should you tell him about this mass?
It is a likely to disappear within the year
A pregnant patient comes in experiencing a sensation of fullness with tingling, tenderness and a bilateral increase in her breast size. What advice will you give her?
Make sure she has a properly fitting bra
A pregnant woman in her 2nd trimester comes to your office for a prenatal visit. On exam you note vascular structures have developed on her upper chest, arms, neck. They are bluish in color and don't blanch with pressure. What causes them to develop?
Increased levels of circulating estrogen
A postpartum woman comes to your office for a check up. On exam her breasts are full, firm, dense, and slightly enlarged. They are also warm, shiny and painful. How long after the breast fill with milk are these changes not unusual?
These findings are common in the first 24 to 48 hours after breast fill with milk
1 week after a woman's breast fill with milk, the are warm, shiny, and painful. On exam her breasts are full, firm and dense. What is your dx?
mastitis
Risk factors for a clogged duct in a lactating woman?
tight fitting bra and inadequate emptying of the breasts
An older woman comes into your office with painful breasts. Upon further testing you determine her breast pain is a result of fluid filled cysts. What type of therapy can result in this finding?
Hormone replacement therapy.
A woman with a long follicular or luteal phase of the menstrual cycle is at higher risk for developing?
fibrocystic changes
30 year old woman notes bilateral and multiple lumps in her breasts that are tender and increasingly painful premenstrual. Dx?
fibrocystic changes
Which type of breast masses are generally mobile, asymptomatic, found in young women, and do not change with menstrual cycle?
Fibroadenomas
A new solid lesion in the breast of an older woman should be considered _____ until proven otherwise
malignant
Stellate, hard, fixed nodule in the right breast of a 40 year old woman.
cancer
Painless lump in one breast of a 36 year old woman. Lump does not vary with menstrual cycle. Margins are poorly delineated and irregular.
cancer
Five days after hitting her breasts against the steering wheel in a car accident a 45 year old woman comes to your office with a firm, irregular mass in her left breast that has an area of discoloration in the area superficial to it.
fat necrosis
A woman comes to your office because she is having a bloody discharge from her nipple. Upon further examination you discover a 3 cm subareolar ductal tumor. Likely Dx? Next step?
Most likely an intraductal papilloma. Next step is to excise it and rule out malignancy.
Eczematous skin lesion over left breast in a 58 year old woman. Does not respond to steroid therapy. Dx?
Cancer (Paget disease of the breast)
A red scaling, crusty patch over the nipple, areola, and surrounding skin on a 67 year old woman's right breast.
Paget disease of the breast with an underlying ductal carcinoma.
Adult male with gynecomastia. What organs should you check for atrophy or failure?
Testicles and liver
Inflammation of the sebaceous glands in the areola result in?
retention cysts.
Drugs that cause galactorrhea?
phenothiazines, TCAs, estrogens, some antihypertensives
Intrinsic causes of galactorrhea?
Prolactin-secreting tumors, pituitary tumors, hypothyroidism, cushings syndrome, and hypoglycemia
Sudden onset of welling, tenderness, erythema, and heat on the right breast of a new mom. She has chills, fever and is tachycardic. Most likely cause of the infection? She asks if she can continue to breast feed, to which you answer?
Staph aureus; yes she can continue to breast feed.
Menopausal women with bilateral breast pain and tenderness. She has a spontaneous sticky, multicolored discharge from multiple ducts on her breast. Dx? Does it increase risk for developing a malignancy?
DX: mammary duct ectasia. Does not increase risk of malignancy.