| Question |
Answer |
| What are the 6 lymph nodes associated with the breast? |
Brachial nodes
subscapular nodes
infrascapular nodes
internal mammary nodes
anterior pectoral nodes |
| Where do the lymph nodes drain? |
Toward axillary chain, the opposite breast or even the abdomen |
| Thelarche |
around 0.8 years old and is 1-2 years before th onset of menarche |
| What does asymmetry of the breast tissue during development indicate? |
nothing |
| What happens to breasts during pregnancy? |
ducts increase in size and number with vascular engrogement |
| What happens to breasts after menapause? |
less support with fatty replacement |
| What is the most common breast mass? |
Benign cysts (fibrocystic change) |
| What causes benign cysts? |
occurs with cyclic hormonal stimulation |
| What is the shape of benign cysts? |
round to elliptical |
| What is the mobility of benign cysts? |
Freely mobile |
| What is the texture of benign cysts? |
soft to firm |
| Is there dimpling or retraction with benign cysts? |
no |
| Are benign cysts tender? |
They may be tender |
| What kind of mass is fibroadenoma? |
benign, round and solid |
| What is the shape and mobility of fibroadenoma? |
Well demarcated (obvious borders) and freely mobile |
| Are fibroadenoma tender? |
no |
| What is the texture of fibroadenoma? |
rubbery and firm |
| Is there retraction or fixation with fibroadenoma? |
no |
| What are fibroadenoma? |
breast tumors that are made of glandular and fibrous breast tissue |
| What shape is breast CA? |
irregular in contour |
| What is the consistency of breast CA? |
firm and hard |
| What are the boarders of breast CA like? |
no well delineated borders |
| What kid onf skin texture does breast CA have? |
dimpling, retraction and fixation |
| Is breast CA tender? |
no |
| What is gynecomastia? |
male breast development |
| How common is gynomastia and around what age? |
in a 2 out of 3 males around 13-14 years old |
| What should you consider with gynomastia? |
normal puberty
drugs-marijuana
hormone imbalance
testicular/pituitary tumor |
| What are the 13 risk factors for breast CA? |
Early Menarche (before 13)
Late menopause (after 52)
Nullipartiy or low parity
Late age at birth of firrst child (age 30)
High socioeconomic status
Caffeine and EtOH consumption
Age greater than 40
Female
Hormone replacement therapy
Proliferative |
| How many women with breast CA have a family history of it? |
10-20% |
| What are the genetic markers for breast CA? |
BRCA 1, BRCA 2, p53, and her-2 |
| What is galactorrhea |
milk secretion |
| What must you rule out with galactorrhea? |
pregnancy, check TSH and Prolactin.
Check medication list |
| What do you 4 things are seen in inspection for in the breast exam that may indicate breast CA? |
retractions
dimpling
peau d'orange
unilateral prominent venous network |
| How should the patient be positioned during inspection? |
With arms at side, over head, pushing on hips and leaning forward. |
| What are retractions in the breast? |
contraction of fibrotic tissue that can occur with carcinoma |
| What is dimpling of the breast? |
Contraction of fibrotic tissue that occurs with carcinoma |
| What is peau d'orange? |
orange in color/ texture is dimpled appearance like an orange peel. |
| What does peau d'orange indicate? |
edema of the breast caused by blocked lymph drainage with inflammatory breast CA |
| What are unilateral prominent venous network? |
produced by dilated superficial veins from increased blood flow to a malignancy |
| How is the breast divided? |
Into 4 quadrants along with the tail of spence extending into the axilla |
| How are the axilla and supraclavicular areas of teh breast palpated? |
while the patient is seated |
| How is teh breast palpated while the patient is supine? |
Vertical Strip method |
| What age does fibrocystic dease happen? |
20-49 |
| What age does fibroadenoma occur? |
15-55 |
| What age is breast ca usually seen? |
30-80 |
| How does fibrocystic disease occur? |
usually bilaterally |
| How does fibroadenoma usually occur? |
usually bilateral |
| How does breast ca usually occur? |
usually lateral |
| How many cysts may occur in fibrocystic disease? |
multiple or single |
| How many areas appear with fibroadenoma? |
single but may be multiple |
| How many masses appear with breast CA? |
single |
| What is the mobility of breast CA? |
fixed |
| In what condition is there variation with menses? |
fibrocystic disease |
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