Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
1. Complications associated w/Benign fibrocystic changes of the breast?
|
a. Can lead to difficulty in detecting breast carcinoma by physical exam and mammography.
|
|
|
2. What lesion of the breast are not associated w/increased risk of breast cancer?
|
a. Adenosis
b. Apocrine metaplasia c. Cysts d. Ductal ectasia e. Fibroadenoma f. Fibrosis g. Mild hyperplasia h. Mastitis i. Squamous metaplasia |
|
|
3. For pts whose mother developed premenopausal breast cancer and who has clinically benign, fibrocystic changes in both breasts and a screening mammogram showing no abnormalities, what is the ultimate decision regarding therapy or surveillance based on?
|
1. Risk factors!
2. Effectiveness of surveillance 3. Anticipated cosmetic results of a biopsy and/or tx. 4. Her concerns about threat of breast cancer b. In this case, breast U/S may provide additional info and should be done to establish a base-line evaluation. |
|
|
4. In the above presentation, tx of pt w/intermediate-risk?
|
a. May be worthwhile to consider chemoprevention. strategies ranging from dietary supplements to antiestrogens.
|
|
|
5. Presentation of Invasive Lobular Carcinoma (10-15% of all breast cancers)?
|
a. Frequently do not appear as dominant breast masses but instead as focal thickening (resembling fibrocystic changes).
b. Mammography of these lesions has a tendency to be Negative!!!!! |
|
|
6. How are Invasive Lobular Carcinomas detected?
|
a. Detection is by physical exam, MRI, and U/S.
|
|
|
7. Atypical ductal hyperplasia?
|
a. When this condition is diagnosed during core needle biopsy, 25-40% of pts have ductal carcinoma in situ diagnosed on excisional biopsy.
|
|
|
8. False-negative rate of screening mammography?
|
a. 10-15%.
|
|
|
9. False-positive rate of screening mammography?
|
a. 10%.
|
|
|
11. Utility of U/S with breast?
|
a. Can visualize solid and cystic lesions (2-5 mm).
b. May be useful for the evaluation of cystic lesions and evaluating a low-risk pt w/a palpable abnormality and a negative mammogram. |
|
|
12. Characteristics of a benign-appearing cyst?
|
a. Absence of septation and a solid component.
b. This has a 99.5% negative predictive value for cancer. |
|
|
13. What is an additional application of breast U/S?
|
a. To differentiate benign and malignant characteristics of solid breast masses.
|
|
|
14. Chemoprevention for ER+ breast CA?
|
a. Tamoxifen (20 mg/day for 5 yrs) has been approved for chemoprevention in high-risk pts and has been reported to reduce the occurrence of subsequent cancer among high-risk pts.
|
|
|
15. What must chemoprevention w/Tamoxifen be weighed against?
|
a. Thromboembolic complications
b. Endometrial cancer c. SE of tamoxifen. |
|
|
16. Utility of MRI for breast masses?
|
a. A useful technique for defining the local extent of breast cancers.
b. It is sensitive to identifying small cancers in the breast, but it lacks specificity in that lesions identified as abnormal may not be cancerous (sensitivity, 90-95%) c. Specificity (45%). |
|
|
d. Note: In premenopausal pts, MRI is even less useful in differentiating hormone-induced changes caused by cancers.
|
d. Note: In premenopausal pts, MRI is even less useful in differentiating hormone-induced changes caused by cancers.
|
|
|
17. How much is the risk of developing breast cancer increased in a woman whose mother or sister has had breast cancer?
|
a. 1.8x.
b. The risk is further increased if the disease was diagnosed in the first-degree relative at a premenopausal age (3.0-fold risk) or if it was bilateral breast-CA (4-5.4x if post-menopausal and a 9x increase in premenopausal). |
|
|
18. Tx options for low-risk benign breast lesions?
|
a. Can be observed or excised based on pt’s clinical presentation and/or preference.
|
|
|
19. Tx options for high-risk breast lesions?
|
a. May opt for excision w/observation and/or chemoprevention w/antioestrogen therapy and close observation.
b. Selective pts w/ a strong family hx or known BRCA gene mutation may be treated w/prophylactic mastectomy and/or bilateral oopherectomy. |
|
|
20. How should all high-risk pts be followed regardless of tx selected?
|
a. Annual mammography and a physical exam and instructed on performing monthly breast self-exam.
|
|
|
21. Screening ductal lavage?
|
a. A new technology useful in the surveillance of pts w/high-risk lesion or high-risk profiles.
b. It involves aspiration of the areola to induce nipple discharge. c. The effluent produced is analysed by cytology. |
|
|
22. Breast CA risk w/LCIS?
|
a. 10x increased risk of subsequent breast cancer.
b. This increased risk is bilateral. c. LCIS is considered a marker for subsequent breast cancer and NOT an early stage of existing breast cancer. d. The subsequent breast cancer development can be in the form of invasive ductal cancer or invasive lobular cancer. |
|
|
23. Most appropriate management recommendation for LCIS?
|
i. Intensified surveillance and chemoprevention w/tamoxifen.
b. This is justified based on the potential future breast cancer in this pt. |
|
|
24. What is the diagnosis of atypical ductal hyperplasia (ADH) by core needle biopsy associated with in future excisional biopsies?
|
a. Findings of invasive or in situ ductal carcinoma.
b. ADH is believed to represent a carcinogenic progression of the ductal epithelial cells. c. Even if the subsequent excisional biopsy demonstrates no evidence of cancer, what should the pt be advised of? i. Their increased risk of cancer and need for f/u and surveillance mammography. |
|
|
25. For very high risk pts such as those w/fam hx of BRCA mutations, when should annual surveillance mammography begin?
|
a. At age 25 or 5-10 yrs prior to the earliest familial case.
|
|
|
26. Why is mammography in women <30 less sensitive?
|
a. Bc of the possibility of dense fibrocystic changes.
|
|
|
27. Complete
|
27. Complete
|
