Breast

Question 1

Dx of Breast

Answer 1

1. Fibrocystic Breast Condition
2. Fibroadenoma
3. cyst
4. intraductal papilloma
5. blocked milk duct
6. mastitis
7. phyllodes tumor
8. atypical hyperplasia

Question 2

fibrocystic breast condition CP

Answer 2

s/s- lumpiness, thickening, swelling, pain, tenderness

cp- menstruation, lactation

Question 3

what is most common benign breast mass

Answer 3

fibroadenoma

Question 4

adenoma means

Answer 4

mass, does not mean CA

Question 5

intraductal papilloma CP

Answer 5

• grows in milk ducts of breast
• bengin
• cp- often w/ nipple discharge

Question 6

mastitis

Answer 6

infection of fatty tissue of breast

• caused by bacteria
• s/s warm, tender, painful
• cp- lactating, fevers, chills, warmth, pain

Question 7

phyllodes tumor

Answer 7

• 1% breast tumors

- can be benign, intermediate, malignant

Question 8

location of phyllodes tumor

Answer 8

• connective tissue of breast (sarcoma)

- tumor not in ducts or lobules

Question 9

atypical hyperplasia

Answer 9

accumulation of abnormal cells in ducts or lobules of breast

- can lead to BC

Question 10

hyperplasia means

Answer 10

proliferation

Question 11

screening tools

Answer 11

1. mammography
2. tomosynthesis
3. US
4. MRI
5. fast MRI
6. CBE

Question 12

mammography

Answer 12

low energy x-ray

- screening or dx

Question 13

what is suspicious for malignancy on mammography

Answer 13

microcalcificaitons

Question 14

US

Answer 14

• aids in detection of hard to see tumors
• differentiates between solid or fluid filled masses
• often after mammogram and before bx

Question 15

tomosynthesis

Answer 15

3D imaging

• earlier detection of small BC than 2D
• greater accuracy

Question 16

MRI indications

Answer 16

1. F with BC gene, BRCA1 or BRCA2
2. F w/ 1st deg relative w/ BC gene
3. F w/ lifetime risk of 20-25% based on BC predicition model
4. radiation to chest between 10-30 yrs
5. various rare syndromes that have higher incidence of BC

Question 17

fast MRI

Answer 17

• self pay
• ideal for candidates that have dense breast tissue or other high risk factors that do not meet qualifications for traditional MRI screening
• does not detect spectrum of dx that can be detected by conventional MRI
• not intended to replace mammogram

Question 18

Risks for BC

Answer 18

1 FEMALE

2. aging
3. FH
4. risk doubles if 1st deg relative w/ BC
5. age at menarche
6. age of 1st live birth
7. age of menopause
8. obesity
9. ETOH
10. BRCA 1, BRCA2
11. male BRCA II Mutation

Question 19

non invasive BC

Answer 19

• ductal carcinoma in situ

- most common noninvasive BC

Question 20

DCIS recurrance risk of DCIS or invasive

Answer 20

30%

Question 21

DCIS

Answer 21

presence of abnormal cells inside milk duct of breast

- considered earliest form of BC

Question 22

tx DCIS

Answer 22

• lumpectomy followed by radiation will decrease recurrance rate to 15%
• sometimes masectomy

Question 23

invasive c

Answer 23

1. inflammatory BC
2. invasive ductal carcinoma
3. metaplastic BC
4. medullary carcinoma
5. Paget’s dx of nipple
6. tubular carcionma
7. paget’s dx of nipple
8. invasive lobular carcinoma
9. angiosarcoma
10. mucinous carcinoma

Question 24

inflammatory BC (IBC)

Answer 24

• Advance, invasive, aggressive
• Starts in milk ducts
• Invades skin and lymph system
• No breast lump or mass
• Not painful
• Subcutaneous change of skin

Question 25

invasive ductal carcinoma (IDC)

Answer 25

- most common, 8/10 CA | - male breast CA

Question 26

metaplastic BC

Answer 26

- “changed form” – looks like cells from other parts of body; squamous or osseous - Treated aggressively - Prognosis uncertain - Metaplastic = metamorphosis

Question 27

medullary carcinoma

Answer 27

- resembles medulla tissue | - better prognosis

Question 28

tubular carcinoma

Answer 28

- rare, 2% - good prognosis - cells resemble small tubes

Question 29

Paget's dx of nipple

Answer 29

- Rare - CA under skin - Redness, scaly, flaky skin - CA cells move through ducts to nipple i. Nipple skin cells spontaneously change to CA cells

Question 30

papillary carcinoma

Answer 30

- Type of DCIS - Cells resemble fingers or threads - Rarely invasive, stays contained in ducts

Question 31

invasive lobular carcinoma (ILC)

Answer 31

- 10% of all invasive BC - Leaves lobules and spreads to fatty tissue and other breast tissues - Ability to metastasize

Question 32

angiosarcoma

Answer 32

- Rare, aggressive - Forms in cells that line blood vessels within breast or axilla - Can be caused by radiation

Question 33

mucinous carcinoma

Answer 33

- produces mucous - good prognosis - rare

Question 34

breast pathology

Answer 34

1. invasive or non-invasive 2. tumor size 3. cell grade [not stage] 4. tumor necrosis 5. vascular or lymphatic invasion 6. hormone receptor status 7. HER2 status 8. surgical margins

Question 35

BC tx

Answer 35

1. systemic therapy- chemo 2. local therapy- surgery or radiation 3. immunotherapy 4. hormonal therapy 5. targeted therapy 6. biotherapy

Question 36

adjuvant

Answer 36

- chemo given after CA is tx to get rid of what tx didnt get

Question 37

neoadjuvant

Answer 37

shrink and debulk tumor before surgery

Question 38

lifestyle changes

Answer 38

1. diet- plant based, low fat, high ca 2. limit ETOH 3. exercise 4. maintain ideal wt 5. ASA

Question 39

CI to BC pills

Answer 39

1. History of DVT/PE 2. Hypertension 3. Those with tobacco use who are over 35 years old 4. Migraines with aura 5. Liver dysfunction 6. Breast cancer [hormones]