The Breast
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x-ray of breast, used to detect tumors & other abnormalities within the breast | mammogram
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lymph node, in group of nodes, located closest to a malignant tumor | sentinel lymph node
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sentinel lymph nodes are examined to determine whether | the tumor has spread to the node
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node dissection would not be required if the sentinel node is not | involved in metastasizing of a malignant tumor
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suspensory ligaments affix the breasts to the | chest wall
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the breast have ___ blood supply | abundant
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the breasts have lymphatic ___ | drainage
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extend from axillae to groin | mammary ridges
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mammary ridges may occasionally produce extra | breasts & nipples
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better contrast, regarding mammogram, would be found on ___ women | younger
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less contrast, regarding mammogram, would be found on ___ women | older
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younger womens' breasts are normally | denser
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older womens' breasts are normally | less dense (lighter)
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mammograms provide better contrast on ___ breast tissue | lighter (less dense)
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involves inspection, palpation, & exam of axillary tissues | clinical exam of the breast
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mammograms are important for detecting lesions invisible to | a clinical exam
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aggravation of unequal sized breasts is more likely to be aggravated by ___ changes, resulting in enlargement of breasts | hormonal
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an irregular response to hormones can cause | benign cystic disease
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well-circumscribed tumor of glandular & fibrous tissue found predominantly in younger women | fibroadenoma
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malignant tumor that is prone to early detection, metastasizing, & late recurrence | carcinoma of the breast
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increased rate of breast carcinoma from hormone treatment can be alleviate by | not using progestin
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a metastasizing breast carcinoma gains movement into other parts of the body through | lymph nodes
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lump on the breast, skin edema, & nipple retraction are all ___ ___ of breast carcinoma | clinical manifestations
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involves combination of surgery and chemotherapy | breast carcinoma treatment
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sarcoma of the breast is a large tumor that is treated through | surgery
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mutations of BRCA1&2 have are at higher risk for breast & ____ carcinoma | ovarian
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carcinoma, benign fibroadenoma, & benign cyst are 3 of the common conditions that cause | a lump in the breast
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persons w/mutations of BRCA1/BRCA2 have greatly increased risk of breast carcinoma as well as ___ carcinoma. | ovarian
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benign cysts, benign fibroadenoma, & carcinoma are common conditions that cause | a lump in the breast
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clinical examination, mammogram, biopsy are used in this order to determine | the nature of a lump in the breast
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the breasts are ___ ___ ___ specialized to secrete milk | modified sweat glands
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the breasts main function is | to produce milk
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the breasts are made up of | glandular and stromal tissues
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the lobules & ducts are made up of ___ tissue | glandular
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the supporting tissue is __; including fatty & fibrous connective tissue | stromal
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the stromal tissue gives the breasts their | size, shape & support
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the breasts are composed of 20 lobes of | glandular tissue
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a cluster of milk-producing glands | lobules
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Each lobe made up of a | lobule
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lobules are connected by | branching ducts
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lobules converge at | the nipple
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bands of fibrous tissue extending from skin of breast to the connective tissue covering chest wall muscles | suspensory ligaments
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axillary lymph nodes | axilla
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lymph nodes above the clavicle | supraclavicular
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lymph nodes beneath the sternum | mediastinal
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axillary nodes are the | supraclavicular and mediastinal nodes
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if breast cancer cells reach axillary nodes & continue to grow, the nodes will swell and cancer is more likely to | spread to other organs
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the breasts contain an abundant blood supply and | lymphatic drainage
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most lymph vessels of breast lead to the | axillary nodes
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during puberty the breasts enlarge in response to | estrogen and progesterone
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accumulation of adipose tissue & proliferation of glandular and fibrous tissue are | post-pubertal changes
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variations in breast size depend on amount of ___ tissue rather than glandular tissue | stromal
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the breasts are extremely responsive to | hormonal stimulation
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mild cyclic hyperplasia followed by involution of breast tissue occurs normally during | the menstrual cycle
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pregnancy & lactation cause hypertrophic | glandular and ductal tissues
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after menopause the sex hormone levels decline, and the breasts | decrease in size
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ages 35-40 are the baseline for mammograms to identify ___ not detected on clinical exams | lesions
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from age 40 and up a mammogram should be done | annually
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show up white on mammogram | denser cysts & tumors
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show up dark on mammogram | less dense fatty tissue
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are well circumscribed on mammogram | cysts & benign tumors
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have irregular borders & frequently contain fine flecks of calcium, on mammogram | malignant tumors
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most commonly found in the armpits or on lower chest below and medial to the breasts | accessory breasts and nipples
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at puberty, one or both breasts over-respond to hormonal stimulation | breast hypertrophy
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true hypertrophy is from overgrowth of | fibrous tissues, not glandular or fatty
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ductal and fibrous tissue of adolescent male breast proliferate affecting one or more breast | gynecomastia
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gynecomastia is from a temporary imbalance of female/male hormones in the male at puberty, there in an increase in | estrogen
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single/multiple benign cystic changes in the breast | fibrocystic disease
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fibrocystic disease proliferates ___ & ___ tissues | glandular; fibrous
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fibrocystic disease is an irregular cyclic response to hormones during | the menstrual cycle
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helpful in distinguishing a cystic from a solid mass | ultrasound examination
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aspiration of &/or surgical excision if no aspiration is obtained/able to be performed | treatment for fibrocystic disease
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fibroadenoma treatment includes | surgical excision
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familial tendency, hormonal factors, birth of first child after age 30, early menarche & late menopause, both sexes are affected, & occurs 1 in every 10 women | breast carcinoma risk factors
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synthetic compound with progesterone activity | progestin
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increases density of breast tissue, complicating the interpretation of mammograms | estrogen-progestin hormone therapy
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increases breast and ovarian carcinoma risk, breast cancer risk at 80%, ovarian cancer risk is at 20–40%, & is a large gene with many different mutations | BRCA1 gene
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breast cancer risk at 80% & a lower ovarian carcinoma risk at 10–20% | BRCA2 gene
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lump in the breast, nipple or skin retraction, & skin edema (orange peel sign) are all | clinical manifestations of breast carcinoma
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90% of breast carcinomas are | ductal carcinomas
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10% of breast carcinomas are | lobular carcinomas
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confined initially within the duct or lobule then becomes invasive & extends toward adjacent breast tissue | Non-infiltrating or in-situ cancer
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site of origin, presence/absence of invasion, & degree of differentiation of tumor cells | classification of breast carcinoma
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cells that resemble normal breast tissue are | well-differentiated
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bizarre cells arranged haphazardly; immature; very different from normal breast tissue | poorly-differentiated
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also called total mastectomy with axillary lymph node dissection; resecting entire breast, axillary tissue w/lymph nodes; leaves pectoral muscles may be followed by breast reconstruction | modified radical mastectomy
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removing only part of breast with the tumor | partial mastectomy
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removing tumor + small amount of adjacent breast tissue | lumpectomy
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axillary lymph nodes removed followed by radiation to eradicate any remaining carcinoma in the breast | lumpectomy and partial mastectomy
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anticancer drugs | adjuvant chemotherapy
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anti-estrogen drugs | adjuvant hormonal therapy
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in order to eradicate any tumor cells that may have spread beyond the breast | adjuvant chemotherapy & adjuvant hormonal therapy
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have gene that speeds up growth rate of tumor cells & a less favorable prognosis | HER-2 positive tumors
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part of tumor obtained is surgically tested to detect presence of | estrogen/progesterone receptors & amplification of HER-2 gene
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better differentiated with favorable prognosis | hormone receptor positive tumors
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may receive adjuvant hormonal therapy with antiestrogen drug | patients with ER positive tumors
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tumors with hormone receptors respond to | anti-estrogen adjuvant therapy
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may appear many years after original tumor has been resected or tumor no longer curable, treatment is to control growth, relieve symptoms, and improve quality of life | recurrent or metastatic carcinoma
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hormone receptor status of tumor, age, time since initial treatment to appearance of metastasis are factors to determine treatment of | recurrent carcinoma
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Premenopausal: anti-estrogen drugs / Postmenopausal: aromatase inhibitor drugs are treatments for | hormone-receptor positive recurrent/metastatic tumor
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Hormonal manipulation if unresponsive to tamoxifen or aromatase inhibitor is treatment for | hormone-receptor negative recurrent/metastatic tumor
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To control metastatic deposits in bone and soft tissues | radiation
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arises from fibrous tissue or blood vessels, large bulky tumor, may metastasize widely & treatment is by surgical resection of the involved breast | breast sarcoma
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Created by:
lfrancois
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