Breast PD

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Author:
Aulockhart
ID:
200248
Filename:
Breast PD
Updated:
2013-02-13 03:05:03
Tags:
Breast exam
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Description:
Breast
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  1. Sx early: redness or crusting of nipple skin
    Sx advanced: tingling, itching, sensitivity, burning, nipple pain.
    • Paget's dz of the nipple
    • Dx: biopsy
    • Tx: Surgery
  2. How is LCIS found
    • Incidental on Biopsy 
    • RF inc 1% per year.
  3. Four Phases of Management for Breast mass.
    • Clinical Breast exam
    • Imaging
    • Sampling
    • Treatment
  4. Mastodynia
    • Breast Pain
    • MC premenopausal
    • Noncyclic pain associated with infection or CA
    • If w/ mass or bloody nipple discharge.
    • Tx: NSAIDs, Eve primrose oil, avoid caffeine
  5. Most common mass in <30 y/o
    Smooth, firm, rounded, mobile
    • Fibroadenoma
    • Dx core or excisional bx
    • Size changes with menses or preg
    • Excise if growing or over 30yr/old
    • LTRF = 2.17 for cancer (IDC)
  6. – 10% malignant
    – resembles fibroadenoma
    – Tx is wide local excision
     Cystosarcoma Phyllodes
  7. – Tetrahydrocannabinol use, spironolactone
    – Liver failure
     Gynecomastia
  8. Trichloroacetic acid (chemical peel),
    Reglan, Verapamil, Reserpine
    • Spontaneous, unilateral, bloody, serous
    • Galactorrhea – r/o Prolactinoma
  9. Most common cause of bloody nipple d/c• Diffuse papillomatosis has increased risk of cancer
    Intraductal Papilloma – not premalignant
  10. Nonspontaneous, B/L, multiple ducts,greenish, milky is likely benign.
    • Mammogram/Sonogram/
    • Ductogram/Ductal excision
  11. – S. Aureus, other bacteria (e.g. Strep)
    – Inflammatory Breast Cancer
     Mastitis/Abscess: Etiology
  12. Breast skin - Painful, cordlike superficial thrombophlebitis
     Mondor’s Disease
  13. – FIBROCYSTIC CHANGES
    – NO INCREASED RISK
    NONPROLIFERATIVE
  14. – PAPILLOMATOSIS
    – 1-2X INCREASED RISK OF CANCER
    PROLIFERATIVE
  15. – ATYPICAL HYPERPLASIA
    – 4-5X INCREASED RISK OF CANCER
    ATYPICAL PROLIFERATION
  16. Found in 3% of benign breast biopsies.
    Associated w/ 13% subsequent development of breast cancer (4x risk factor)
    Some may be an under-diagnosed ductal carcinoma in situ
    Excisional Biopsy – do not need clear margins
    • Atypical Hyperplasia - Marked proliferation and atypia of the epithelium, either
    • ductal or lobular.

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