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26 Cards in this Set
- Front
- Back
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Breast cancer incidence, lifetime, for women?
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1/8
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name of the structure that connects the mamary glands to the 20-40 lobules?
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lactiferous ducts
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2 blood sources for the breast?
-locations |
internal mammary artery: inner quadrants
lateral thoracic artery: outer quadrants |
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Discuss how the following hormones are able to contribute to milk production
-estrogen -progesterone -prolactin -oxytocin |
-estrogen: ductal development, fat deposition
-progesterone: stromal development (lobule/alveolar( -prolactin: involved in milk production -oxytocin: milk letdown |
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Describe discharge that is most concerning
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bloody/serosanguinous, unilateral, spontaneous, from a single duct --> these are all associated with a mass
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Compare:
bloody discharge vs. serous discharge vs. milky discharge vs. yellow-tinged vs, purulent discharge |
Bloody: intraductal papilloma, invasive papillary cancer
Milky: pregnancy, pituitary adenoma, hypothyroidism Serous: Normal menses, OCPs, fibrocystic change, early pregnancy Yellow-tinged: fibrocystic change, galactocele (tumor [benign] in the milk ducts) purulent: abscess |
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Imaging modalities of breast cancer
-under 30 -over 30 |
-over 30: mammography
-under 30: ultrasound (highly dense breast tissue) |
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What is the appropriate evaluation technique for a nonpalpable abnormal mammogram finding?
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wire guided excision
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what is the appropriate evaluation technique for a solid palpable mass
-under 30 -over 30 |
under 30: FNA
over 30: core needle biopsy |
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If an FNA is nondiagnostic, the next step is to perform...
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an excisional biopsy
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Define: fibrocystic change
-overview -sx -epidemiology |
spectrum of findings related to an *exaggerated stromal response to hormones/growth factors*
-painful breast masses, multiple, bilateral, fluctuate rapidly in size -30-40 is peak age |
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Define: fibroadenoma
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benign tumors with glandular or stromal components
-rubbery, nontender -ages 20-35 |
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Define: cystosarcoma phyllodes
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rare variant of fibroadenoma --> epithelial and stromal proliferation
-rapid grwoth -large mass -most are benign, but have **agressive malignancies** |
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Define: Intraductal papilloma
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-benign solitary lesion that involves the epithelial lining of the lactiferous ducts
-most ocmmon cause of bloody nipple discharge w/out concurrent mass -tx by excising the duct |
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Define: Mammary Duct Ectasia
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subacute inflammation of ductal system, which dilates the mammary glands
benign |
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BIggest risk factor for breast cancer?
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increasing age
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Define: Ligament of Cooper
-what is it -dimpling |
Supportive ligament that holds breast tissue in place. Skin dimpling occurs when tether of hte cooper ligament occrus from masses underneath it.
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Define: Lobular Carcinoma in Situ
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neoplastic epithelial cells w/in th ebreast lobule, no invasion into stroma
observe w/out therapy after biopsy confirmation |
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Differentiate:
-DCIS -LCIS -infiltrating ductal carcinoma -infiltrating lobular carcinoma most common? |
most common is infiltrating ductal carcinoma
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DCIS vs. LCIS
-malignancy potential |
-DCIS has a higher invasive potential than LCIS
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Define: DCIS
-compare to LCIS -detection? -tx? |
-malignant epithelial cells
-higher potential to progress to invasive carcinoma than LCIS -detected with mamography -tx with excision, mastectomy, radiation |
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Name the four types of invasive breast cancer
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-infiltrating ductal carcinoma (70% of breast cancer)
-infiltrating lobular carcinoma -Paget's disease of the nipple --> eczematous change, crusting, scaling, erosion -inflammatory breast carcinoma --> extremely aggressive, dermal lymphatic invasion, *peau d'orange* |
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What are the 3 tumor receptors whose status we check regulalry?
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--Estrogen
--Progesterone --Her2/neu |
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when is adjuvant hormone therapy used?
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in patients who have receptor positive cancers
--> tamoxifen is used, competitively binds estrogen receptors, inhibits the effect of estrogen on breast tissue |
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Followup for breast cancer?
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physical exam every...
-3-6 months until year 3 -6-12 months for years 4-5 -1 year for year 5+ |
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When should women start getting mammograms?
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q1-2 years @40
q1 year @ 50 |
