W&I test2 (part5)
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Mammograms should be done yearly starting at age ____ for the general female population and ___ years prior to disease diagnosis age of 1st degree relative
_______ should be done yearly beginning at age 40 for general female population and 10 years prior to disease diagnosis age of 1st degree relative
What are some issues with breast MRI? (4)
- 1) More sensitive than mammograms
- 2) Expensive!
- 3) More false positives leading to more biopsies of benign lesions
- 4) Now covered as screening for some patients
These are all issues with what breast screening procedure?
A clinical breast exam should be done when? (2)
- 1) Every 3 years ages 20-40
- 2) Yearly for 40+
This is how often what should be done?
Breast self exam (BSE) is option for women ____ +, and sudies have show this does not save lives
___ ___ ___ is option for women 20+, and sudies have show this does not save lives
Name 2 definitivie diagnosis that would indicate a breast biopsy.
- 1) If suspicious mass on imaging (mammogram, MRI, breast ultrasound) OR
- 2) If palpable mass even if imaging studies are negative
Either one of these would indicate the need for what kind of study.
Name two types of breast biopsys?
- 1) Fine needle aspiration (FNA)
- 2) Stereotactic/utrasound core biopsy
These are two types of ______ ______.
This procedure involves the aspiration of cellular fluid by inserting a needle into the lesion in the breast.
Fine needle aspiration (FNA) involves what procedure?
What is done if the fine needle aspiration (FNA) is negative.
A more difinitive biopsy is warrented if an FNA is _____.
This type of biopsy of the breast involves a gun device that removes a core sample of the lesion with several areas sampled
What are the advantage over open surgical biopsy: (5)
- a) Stereotactic/utrasound core biopsy invoves what procedure?
- b) Less scarring, local anesthesia, outpatient procedure, lower cost, and it's a reliable diagnostic technique
Name some benign breast disorders. (4)
- 1) Mastalgia (breast pain)
- 2) Fibrocystic breast changes
- 3) Fibroadenoma
- 4) Mastitis
These are types of what breast disorders?
What differentiates Cyclic from noncyclic masalgia.
Cyclic masalgia is related to hormonal changes noncyclic is not.
Discribe the symptoms of cyclic mestalgia. (2)
- 1) Diffuse tenderness or heaviness in the breasts
- 2) Often decreases with menopause
These are symptoms of _____ _____.
Discribe noncyclic mestalgia. (2)
- 1) Burning, aching, or soreness
- 2) May be due to trauma, fat necrosis, or ductal ectasia
These are symptoms of _____ _____.
Name some managements for mastalgia. (4)
- 1) Mammogram or other imaging to rule out cancer or ID source of pain
- 2) Decrease caffeine, dietary fats
- 3) Vitamins E, A, B complex
- 4) Gamma-linoleic acid (evening primrose oil)
These are all managements for _______.
What are some fibrocystic breast changes. (4)
- 1) Development of excess fibrous tissue
- 2) Hyperplasia of the epithelial lining of the mammary ducts
- 3) Proliferation of mammary ducts
- 4) Cyst formation
These are types of what changes?
In fibrocystic breast changes they are usually located where?
In ______ breast changes they are usually located bilaterally most prominently in the upper , outer quadrants.
In fibrocyctic breast changes they are often _____ and ______ to hormonal influence.
In ____ ____ ____ they are often tender and sensitive to hormonal influence
1) Usually a small, painless, round, well delineated, firm, unilateral mass
2) Generally occurs in women ages 15-25
3) Size not affected by menstruation, but may grow during pregnancy
4) Rarely associated with cancer
These are a discription of what breast disorder.
Localized tenderness, erythema and inflammation of the breast di r bes what breast disorder?
Mastitis is most commonly seen in _____ women. It's usually cause by the introduction of _________ bacteria through a cracked or abraded nipple
______ is most commonly seen in lactating women. It's usually cause by the introduction of Staphylococci bacteria through a cracked or abraded nipple
It is ok to nurse with mastitis unless what?
Unless prurulent drainage is noted it is ok to ____ with mastitis
What is the treatment for mastitis.
Antibiotics are the treatment for what breast disorder?
What can happen if insufficient antibiotic treatment is used with mastitis?
Can develop into an abcess (collection of purulent fluid) if insufficient antibiotic treatment is used with _______.
Discribe some statistics of breast cancer. (5)
- 1) Follows skin cancer as the most common malignancy in American women
- 2) Follows lung cancer as the leading cause of death from cancer in women
- 3) White women have higher incidence of breast cancer
- 4) African American women have lower survival rates than white women even with early diagnosis
- 5) Incidence and mortality rates lower among Hispanic and Asian/Pacific Islander women even though Hispanic women have lower screening rates and tend to be diagnosed at later stages
These are statistics of what breast disorder?
Name some risk factors for breast cancer. (9)
- 1) Female (99% of all cases)
- 2) Age 50+
- 3) Family history:
- •1st degree relative (parent or sibling)
- •BRCA-1, BRCA-2 mutations in 5-10% of cases
- 4) Personal history of breast, colon, endometrial, or ovarian cancer
- 5) Menarche <age 12, Menopause >age 55
- 6) First full-term pregnancy >30, nulliparity
- 7) Atypical epithelial hyperplasia, lobular carcinoma in situ
- 8) Weight gain and obesity after menopause
- 9) Exposure to ionizing radiation
These are all risk factors for what breast disorder?
Hormone replacement therapy has show what when it comes to breast cancer?
_____ _____ therapy has show a slight increase is breast cancer
What are the findings with birth control pills and breast cancer?
___ ___ pills show no increased risk for developing breast cancer.
How does alcohol effect breast cancer.
Studies show that ______ consuption increases the risk for breast cancer.
5-10% of all breast cancers are related to what genes.
___-___% of all breast cancers are related to the BRCA-1 and BRCA-2 genes.
The BRCA-1 and BRCA-2 genes show a ___-___% lifetime risk for developing breast cancer and is associated with increased risk for ovarian cancer.
The _____ and _____ genes show a 40-80% lifetime risk for developing breast cancer and is associated with increased risk for ovarian cancer.
What are the preventive options if a patient is DNA tested for the BRCA-1, and BCRA-2 genes and is positive. (2)
- 1) Prophylactic mastectomy
- 2) Oophorectomy
These are options for patients who tested positive for the ____ and ____ gene.
What are some factors affecting the prognosis of breast cancer? (6)
- 1) Tumor size
- 2) Axillary node involvement
- 3) Tumor differentiation
- 4) Human epidermal growth factor receptor 2 (HER2) status
- •A receptor that helps regulate cell growth and is often overexpressed in patients with breast cancer
- •Historically poor prognostic indicator if present
- 5) Estrogen and progesterone receptor status
- 6) TYPE of cancer seems to have little prognostic significance once the cancer has metastasized
These are all factors affecting the prognosis of ____ _____.
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