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fibroadenoma dif
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fibroadenoma px
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breast

usmle breast cancer

TermDefinition
fibroadenoma dif most common benign breast tumor in women under 30
fibroadenoma px painless mass, well defined, rubbery, mobile, hormone dependent, firm
fibroadenoma dx 1st sonography , FNA , biopsy
fibroadenoma tx conservation, excision if 2-3 cm and rapidly growing on serial US
giant juvenile fibroadenoma dif prepubretal or young girl
giant juvenile fibroadenoma px breast mass getting bigger , well defined, rubbery, mobile, hormone dependent, firm . may destort devolpment of the breast
giant juvenile fibroadenoma dx 1st sonography , FNA
giant juvenile fibroadenoma tx always surgery excision
intraductal papiloma dif most common of case bloody discharge from nipple
intraductal papiloma dx mamography to rule out breast cancer
intraductal papiloma tx surgical excision of involved duct
breast abscess dif most common in woman post partum or breast feeding, pt may have been diagnosed with mastits
breast abscess px unilateral localized pain, tenderness, eryhtema, subareolar mass, nipple discharge, nipple inversion, LAN, systemic symptoms of infection
breast abscess dx sonography
breast abscess tx surgical drinage, biopsy of the wall, culture the pus anti staph ABS ( nafcillin, oxicillin)
breast cysts dif common breast masses can be from various causes, usally painless
breast cysts to confirm songraphy
breast cysts dx/tx 1st step - needle drainage if clear fluid or greenish SIMPLE CYST, benign no further steps. if fluid milky GALACTOCELE , benign no further steps. if fluid bloody MALIGNANT should be excision if the cyst continues recur even its benign excision
mammary duct ectasia dif obstruction of a subareolar dusct leading to duct dilation, inflamation, and fibrosis
mammary duct ectasia px breast pain, nipple retracion, subalveolar mass, sticky discharge,
mammary duct ectasia dx mamography
mammary duct ectasia tx surgery
breast cancer risk factor femail, age >40, hx of BC, 1st degree relative w/ BC, nulliparty, 1st pregnancy >30, menrache <12, menopause >55, radiation, >5 years HRT
breast cancer genitic BRCA 1/2, li-fraumeni syndrome p53
breast cancer for whom we do gentic screening pt diagnosed with breast and ovarian canver. strong Fx of breast/ovarian cancer. Fx of male breast cancer. young pt (<35years)
breast cancer when suspect ? usually painless, breast mass, ill defined mass, FIXED mass, skin changes ( orange peeling, dimpling, erythema), nipple retraction,axilary LAN
ductal carcinoma in situ tx * lumpectomy + radiation ( reccurence 5-10%) * modified radical mastectomy ( reccurence <1%)
lobular carcinoma in situ dif most common to find incidentaly, marker for increase of invasive cancer in either breast
lobular carcinoma in situ tx *1 qd observation, * lumpectomy + radiation ( reccurence 5-10%) * modified radical mastectomy ( reccurence <1%) *prophylactic bilateral mastectomy
infiltrating ductal carcinoma dif most common breast cancer 80%
infiltrating ductal carcinoma tx surgery : * lumpectomy and senetile node biopsy + radiation. * modified radical mastectomy . *radical mastectomy if inavion of pec major chemotherapy : *CAF,CMF hormone therapy( if tumor is ER/PR+) *estrogen inhibitor ( tamoxifien, raloxifien)
infiltrating lobular carcinoma dif strong tendency toward bilaterlity
infiltrating lobular carcinoma tx surgery : * lumpectomy and senetile node biopsy + radiation. * modified radical mastectomy . *radical mastectomy if inavion of pec major chemotherapy : *CAF,CMF hormone therapy( if tumor is ER/PR+) *estrogen inhibitor ( tamoxifien, raloxifien)
positive anti-her 2/neu trastuzumab
postive ER or RR tamoxifen, rolaxifen
lumbectomy contraindication cancer is multifocal or radiation is contraindication
adjuvant chemotherapy is the answer when lesions >1cm, postive axillary lymph nodes
when sentinel lymph node biopsy the answer? routinely in all pts at the time of lumpectomy or mastectomy
when PET scan the answer ? content of abnormal lymph nodes that are note easy accessible to biopsy
when ultrasound the answer ? indetrminant mass lesion, cysts VS solid lesions ... painful , varies in size or pain with menstruation
FNA best initial biopsy
open biopsy most accurate diagnostic
core needle biopsy larger sample, more deforming, can test ER, PR, HER 2/neu
Created by: Drsakhnini
 

 



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