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28 Cards in this Set

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What are Cooper's ligaments?
• connective tissue structures that are derived from the superficial fascia of the skin
• suspends the breast on the chest wall
• retraction of Cooper's ligaments can produce skin dimpling
What are acini (in female breasts)?
proliferations of the terminal ducts lined with secretory cells for milk production
What are the American Cancer Society Recommendations for breast cancer detection in asymptomatic women ages 20-39? ages > 40?
• 20-39:
- clinical breast exam » every 3 years
- breast self-exam » monthly (optional)
- mammogram » N/A

• > 40:
- clinical breast exam » yearly
- breast self-examination » monthly (optional)
- mammogram » yearly
When is ultrasound most useful in breast examination?
• can characterize palpable lesions or suspicious areas found on mammogram or physical examination (especially in women where likelihood of breast CA is low)

• can distinguish solid masses from cysts and simple cysts from complex cysts
What are different breast biopsy options?
• Fine-needle aspiration cytology
• Core-needle biopsy
• Open biopsy (either excisional or incisional)
This is a very common benign tumor of the breast that usually occurs in young women
Fibroadenoma
Describe typical characteristics of a fibroadenoma upon palpation
• 1-3 cm in size
• freely movable, discrete, firm, rounded mass
Which type of breast mass resemble normal mammary lobules in that they show lactation in pregnancy and involution in menopuase?
fibroadenoma
What is the most common cause of breast mass in women in their fourth and fifth decades of life?
breast cyst
Describe typical characteristics of breast cysts upon palpation
• may be solitary or multiple
• presents as firm, mobile, slightly tender masses
• often has less well-defined borders compared to fibroadenomas
What is the most common cause of nipple discharge?
duct ectasia (a nonneoplastic condition characterized by multiple dilated ducts in the subareolar space)
What is the cause of most cases of unilateral, bloody nipple discharge?
intraductal papilloma
What are different histologic types of breast cancer?
• Colloid or mucinous carcinoma
• Ductal carcinoma in situ (DCIS)
• Infiltrating ductal carcinoma
• Infiltrating lobular carcinoma
• Inflammatory carcinoma
• Lobular carcinoma in situ (LCIS)
• Medullary carcinoma
• Paget's disease of the nipple
• True papillary carcinoma
• Tubular Carcinoma
This is a preinvasive form of ductal cancer which can develop into invasive cancer if not treated adequately
Ductal carcinoma in situ (DCIS)
What is the typical appearance of DCIS on mammography?
microcalcifications (rarely a mass on pohysical examination or mammography)
This type of breast cancer consitiutues approximately 90% of invasive breast cancer and produces the characteristic firm, irregular mass on physical examination.
infiltrating ductal carcinoma
This type of breast cancer makes up approximately 10% of breast cancers and is often difficult to detect on mammogram or physical exam because of its indistinct borders.
infiltrating lobular carcinoma
What are chacteristics of tubular carcinoma?
• well-differentiated form of ductal carcinoma
• forms small tubules, randomly arranged, each lined by a single uniform row of cells
• tends to occur in women who are slightly younger than the average patient with breast cancer
What are characteristics of medullary carcinoma?
• another form of infiltrating ductal cancer
• characterized by extensive tumor invasion by small lymphocytes
• less commonly metatasizes to regional lymph nodes
Which type of breast cancer is characterized histologically by clumps and strands of epithelial cells in pools of mucoid material?
Colloid or mucinous carcinoma
What are the most common areas of breast cancer metastasis?
• bone
• lung
• liver
• brain
Describe the tumor classification of the TMN stagaing system for breast cancer
• Tis: Carcinoma in situ
• T1: Tumor < 2 cm
• T2: Tumor 2-5 cm
• T3: Tumor > 5 cm
• T4: Tumor any size with extension to chest wall or skin
Describe the classification of lymph node involvement in the TMN staging system for breast cancer
• N0: no lymph node metastasis
• N1: metastasis in 1-3 axillary lymph nodes
• N2: metastasis in 4-9 axillary lymph nodes
• N3: metastasis in 10 or more axillary lymph nodes
Describe the different classifications of metastasis in the TMN staging system for breast cancer
• M0: no distant metastasis
• M1: distant metastasis
Differentiate between simple/total, modified radical, and radical mastectomy
• Simple, or total, mastectomy removes the entire breast with the pectoralis major fascia
• Modified radical mastectomy is a simple mastectomy with axillary dissection
• Radical mastectomy removes the breast, both pectoralis muscles, axillary contents, and overlying skin
Which nodes are removes in axillary dissection?
• removes level I and level II lymph nodes
• includes nodes in the axillary fat pad, below the pectoralis major muscle, and behind the pectoralis minor muscle
What is the most common chemotherapy regimen used to treat breast cancer?
• cyclophosphamide
• doxorubicin
• 5-fluorouracil

* given over 9-10 weeks at 3-week intervals
What hormonal therapy is used to treat estrogen-receptor-positive tumors (particularly in postmenopausal women)?
Tamoxifen